| Sanford Health Psychology | |
|
1720 University Dr S Fargo ND 58103-4940 | |
| (701) 234-5000 | |
| (701) 234-2045 |
| Full Name | Sanford Health Psychology |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1720 University Dr S, Fargo, North Dakota |
| Authorized Official Name and Position | Tony Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Psychology Po Box 2168 Fargo ND 58107-2168 Ph: (701) 234-2119 | Sanford Health Psychology 1720 University Dr S Fargo ND 58103-4940 Ph: (701) 234-5000 |
| NPI Number | 1144381328 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Medicare PECOS PAC ID | 8426967803 |
|---|---|
| Medicare Enrollment ID | O20091023000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144381328 | NPI | - | NPPES |
| 1C35HME | Other | MNBC | |
| 735547500 | Medicaid | MN | |
| 0230050 | Medicaid | SD | |
| 003160 | Other | NDBC | |
| 01820 | Medicaid | ND | |
| 1029817 | Other | PREFERRED ONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 5068A (North Dakota) | Primary |
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