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General NPI Number Information
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NPI Number | 1144381328
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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 | 12/12/2006
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 1720 UNIVERSITY DR S
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City | FARGO
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State | ND
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Zip | 58103-4940
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Country | US
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Telephone | 701-234-5000
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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 | 701-234-2119
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Fax | 701-234-2045
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Authorized Official
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Title or Position | VICE PRESIDENT, REVENUE CYCLE
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Name | TONY 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 | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 5068A
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License Number State | ND
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