Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Dialysis Red Lake
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
24760 HOSPITAL DR, RED LAKE, MN 56671
(218) 679-3117
(218) 676-4386
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
(701) 234-2045
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
632605600
—
MN
Enumeration date
12/13/2006
Last updated
11/27/2023
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