| Sanford Medical Center | |
|
512 Main Ave Lake Norden SD 57248-0079 | |
| (605) 873-2222 | |
| (605) 873-2182 |
| Full Name | Sanford Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 512 Main Ave, Lake Norden, South Dakota |
| Authorized Official Name and Position | Tony Lee Morrison (VP, 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 Medical Center Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Medical Center 512 Main Ave Lake Norden SD 57248-0079 Ph: (605) 873-2222 |
| NPI Number | 1417927559 |
|---|---|
| Provider Enumeration Date | 01/23/2006 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 8325950215 |
|---|---|
| Medicare Enrollment ID | O20221227002593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417927559 | NPI | - | NPPES |
| 5300462 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |