Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Pharmacy Broadway, Sanford Pharmacy Roger Maris
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VP REVENUE CYCLE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2416
(701) 234-2433
Mailing address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2416
(701) 234-2433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
309
ND
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
309
ND
3336H0001X
Home Infusion Therapy Pharmacy
309
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235173519
—
MN
05
—
1235173519
—
SD
05
—
21587
—
ND
01
—
35-00712
NCPDP
—
Enumeration date
06/16/2006
Last updated
07/30/2024
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