Sanford Health Lidgerwood Clinic | |
21 Wiley Avenue South Lidgerwood ND 58053-4001 | |
(701) 538-4189 | |
(701) 538-4319 |
Full Name | Sanford Health Lidgerwood Clinic |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 21 Wiley Avenue South, Lidgerwood, North Dakota |
Authorized Official Name and Position | Martha K Leclerc (VP) |
Authorized Official Contact | 7012346248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sanford Health Lidgerwood Clinic 720 Fourth Street S Fargo ND 58122-0605 Ph: (701) 234-2000 | Sanford Health Lidgerwood Clinic 21 Wiley Avenue South Lidgerwood ND 58053-4001 Ph: (701) 538-4189 |
NPI Number | 1255348280 |
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Provider Enumeration Date | 08/02/2006 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255348280 | NPI | - | NPPES |
12857 | Medicaid | ND | |
CF8850 | Other | ND | RAILROAD MEDICARE |
1327001 | Other | ND | BLUE SHIELD |
5135 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |