Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Pharmacy Detroit Lakes
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
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2276
(701) 234-7476
Mailing address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(701) 234-2121
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263507
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124937
PK
—
Enumeration date
04/22/2010
Last updated
12/12/2023
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