Organization Name: | SANFORD MEDICAL CENTER FARGO |
NPI Number: | 1013077007 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA K LECLERC (VP) |
Mailing Address: | 400 E 1st St Morris |
State: | MN US |
Postal Code: | 562671408 |
Phone Number: | 3205892832 |
Fax Number: | 7012342045 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 12/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |