SANFORD MEDICAL CENTER FARGO (NPI# 1558458844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558458844 |
| Entity Type | Organization |
| Organization Name | SANFORD MEDICAL CENTER FARGO |
| Other Organization Name | SANFORD PHARMACY SOUTH UNIVERSITY |
| Practice Address |
1720 S University Drive Fargo ND 58103-4940 |
| Practice Telephone | 7012804469 |
| Practice Fax Number | 7012804643 |
| Mailing Telephone | 7012342121 |
| Mailing Fax Number | 7012804643 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Telephone | 6053288380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 539 | ND | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 3500697 | 01 | |
| MN | 1558458844 | 05 | |
| ND | 21561 | 05 | |
| MEDICA | 8200336 | 01 |
| Other Name | Type Code |
|---|---|
| Sanford Pharmacy South University | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245519081 | Sanford Medical Center Fargo | General Acute Care Hospital | 2990 Seter Parkway, Fargo, ND 58104-8750 | 2011-08-10 |
| 1578508198 | Sanford Medical Center Fargo | Clinic/Center | 1234 Washington Ave Ste B, Detroit Lakes, MN 56501-3906 | 2006-06-18 |
| 1225635634 | Sanford Medical Center Fargo | Pharmacy | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-08 |
| 1174120281 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-10-02 |
| 1013559905 | Sanford Medical Center Fargo | Hospice Care, Community Based | 801 Broadway N, Fargo, ND 58102-3641 | 2019-10-11 |
| 1366092801 | Sanford Medical Center Fargo | Hospice Care, Community Based | 820 4th St N, Fargo, ND 58102-4539 | 2019-09-17 |
| 1861927709 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104 | 2017-04-28 |
| 1801151394 | Sanford Medical Center Fargo | Clinic/Center | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-07-10 |
| 1366717118 | Sanford Medical Center Fargo | Clinic/Center | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2012-03-13 |
| 1861772162 | Sanford Medical Center Fargo | Internal Medicine | 1412 Main Street, Hawley, MN 56549-0746 | 2011-08-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANFORD MEDICAL CENTER FARGO | 720 N 4th St, Fargo, ND 58122-4520 |
| Street Address |
1720 S UNIVERSITY DRIVE |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467855163 | Margaret Hankel | Physical Therapist | 1720 S University Drive, Fargo, ND 58122 | 2014-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1336472505 | Midwest Drug Distribution Inc | Pharmacy | 4153 12 Th Ave. North Suite B, Fargo, ND 58102 | 2009-09-04 |
| 1518098219 | Pharmacare Inc | Pharmacy | 2345 25th St S, Suite C, Fargo, ND 58103-6173 | 2007-03-07 |
| 1588724728 | Metro Drug Co | Pharmacy | 123 Broadway N, Fargo, ND 58102-4925 | 2006-12-11 |
| 1881785053 | Thrifty Drug Limited | Pharmacy | 1532 32nd Ave S, Fargo, ND 58103-5987 | 2006-09-27 |
| 1952407892 | Thrifty Drug Limited | Pharmacy | 1521 University Dr S, Fargo, ND 58103-4169 | 2006-09-16 |
| 1447362454 | W W Inc | Pharmacy | 2800 Broadway N, Fargo, ND 58102-1420 | 2006-08-31 |
| 1538271549 | Ww Inc | Pharmacy | 1605 University Dr S, Fargo, ND 58103-4154 | 2006-08-31 |
| 1912954165 | Medical Pharmacy South Inc | Pharmacy | 4151 45th St S, Fargo, ND 58104-4312 | 2006-05-30 |
| 1225635634 | Sanford Medical Center Fargo | Pharmacy | 1720 University Dr S, Fargo, ND 58103-4940 | 2020-10-08 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.