Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Pharmacy Medical Center Fargo
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5604
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5604
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
315
ND
3336I0012X
Institutional Pharmacy
315
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21557
—
ND
01
—
3500774
NCPDP
—
05
—
725859300
—
MN
Enumeration date
12/29/2006
Last updated
07/15/2013
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