| The Swanson Foundation | |
|
3541 25th St S Ste 200 Fargo ND 58104-5900 | |
| (701) 929-3930 | |
| (702) 205-4765 |
| Full Name | The Swanson Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3541 25th St S Ste 200, Fargo, North Dakota |
| Authorized Official Name and Position | Bets Werpy (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7014917977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Swanson Foundation 809 8th Ave S Fargo ND 58103-2634 Ph: (701) 491-7977 | The Swanson Foundation 3541 25th St S Ste 200 Fargo ND 58104-5900 Ph: (701) 929-3930 |
| NPI Number | 1346914033 |
|---|---|
| Provider Enumeration Date | 08/05/2021 |
| Last Update Date | 10/03/2025 |
| Certification Date | 10/03/2025 |
| Medicare PECOS PAC ID | 4385158872 |
|---|---|
| Medicare Enrollment ID | O20250708001418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346914033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | () | Primary |
| Provider Name | Allan J Luistro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073648259 PECOS PAC ID: 4789083353 Enrollment ID: I20210602000808 |
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