Provider Demographics
NPI:1346914033
Name:SWANSON FOUNDATION
Entity Type:Organization
Organization Name:SWANSON FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BETS
Authorized Official - Middle Name:
Authorized Official - Last Name:WERPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-491-7977
Mailing Address - Street 1:809 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2634
Mailing Address - Country:US
Mailing Address - Phone:701-491-7977
Mailing Address - Fax:
Practice Address - Street 1:3541 25TH ST S STE 200
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5900
Practice Address - Country:US
Practice Address - Phone:701-929-3930
Practice Address - Fax:702-205-4765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty