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A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers |
| NPI # | 1588834501 |
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| LBN Legal business name | SANFORD CLINIC | ||||||||
| Authorized official | LAURIE KUNTSON - (DIR OF CLINIC OPER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 03/05/2008 | ||||||||
| Last updated | 11/27/2023 - About 3 years ago | ||||||||
| Identifiers |
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SANFORD CLINIC
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SANFORD CLINIC