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General NPI Number Information
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NPI Number | 1568469039
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Entity Type | Organization
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Legal Business Name | SANFORD HEALTH NETWORK
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 308 8TH ST N
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City | MOUNTAIN LAKE
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State | MN
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Zip | 56159-1568
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Country | US
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Telephone | 507-427-3332
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Fax | 507-427-2493
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone | 605-328-6585
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Fax |
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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