Healthcare Provider Details

I. General information

NPI: 1548230683
Provider Name (Legal Business Name): SANFORD MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 HOSPITAL DR
ESTELLINE SD
57234-0196
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 605-873-2222
  • Fax: 605-873-2182
Mailing address:
  • Phone: 605-328-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TONY LEE MORRISON
Title or Position: VP, REVENUE CYCLE
Credential:
Phone: 605-328-8380