SANFORD MEDICAL CENTER FARGO; NPI #1073520003

Contact Information

SANFORD MEDICAL CENTER FARGO

336 MAIN STREET
FORMAN, ND 58032-0184

Phone: 701-724-3221
Fax: 701-724-3222
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for SANFORD MEDICAL CENTER FARGO

NPI # 1073520003

LBN Legal business name SANFORD MEDICAL CENTER FARGO

Authorized official TONY MORRISON - (VICE PRESIDENT, REVENUE CYCLE)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/02/2006

Last updated 11/29/2022 - About 4 years ago

Identifiers

ND	Medicaid	12857
ND	Medicaid	5128
ND	Other	1331001	BLUE SHIELD
ND	Other	CF8850	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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