Provider Demographics
NPI:1265678056
Name:STRINDEN VISION
Entity Type:Organization
Organization Name:STRINDEN VISION
Other - Org Name:GRAND FORKS VISION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:PEDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-780-9701
Mailing Address - Street 1:3221 32ND AVE S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6071
Mailing Address - Country:US
Mailing Address - Phone:701-780-9701
Mailing Address - Fax:701-780-9084
Practice Address - Street 1:3221 32ND AVE S
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6071
Practice Address - Country:US
Practice Address - Phone:701-780-9701
Practice Address - Fax:701-780-9084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-28
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND801774OtherBCBS OF ND