Healthcare Provider Details

I. General information

NPI: 1922187988
Provider Name (Legal Business Name): SANFORD HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W 1ST ST
WEBSTER SD
57274-1054
US

IV. Provider business mailing address

PO BOX 489 1401 WEST 1ST STREET
WEBSTER SD
57274-0489
US

V. Phone/Fax

Practice location:
  • Phone: 605-345-3336
  • Fax: 605-345-2402
Mailing address:
  • Phone: 605-345-3336
  • Fax: 605-345-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10573
License Number StateSD

VIII. Authorized Official

Name: MR. BRUCE VIESSMAN
Title or Position: CFO SANFORD HEALTH NETWORK
Credential:
Phone: 605-328-5506