Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Pharmacy I94
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
5225 23RD AVE S, FARGO, ND 58104
(701) 417-2338
(701) 417-2343
Mailing address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 234-2121
(701) 417-2343
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR315A
ND
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169022
PK
—
Enumeration date
04/28/2017
Last updated
09/27/2024
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