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General NPI Number Information
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NPI Number | 1013077007
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Entity Type | Organization
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Legal Business Name | SANFORD MEDICAL CENTER FARGO
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 400 E 1ST ST
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City | MORRIS
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State | MN
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Zip | 56267-1408
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Country | US
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Telephone | 320-589-2832
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Fax | 701-234-2045
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Provider Business Mailing Address
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Address Line | PO BOX 2168
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City | FARGO
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State | ND
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Zip | 58107-2168
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Country | US
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Telephone | 320-589-2832
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Fax | 320-589-9020
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Authorized Official
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Title or Position | VICE PRESIDENT, REVENUE CYCLE
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Name | TONY LEE MORRISON
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Credential |
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Telephone | 605-328-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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