| Sanford Medical Center Fargo | |
|
211 E Mill St Pelican Rapids MN 56572-4234 | |
| (218) 863-6100 | |
| (218) 863-6173 |
| Full Name | Sanford Medical Center Fargo |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 E Mill St, Pelican Rapids, Minnesota |
| Authorized Official Name and Position | Tony Lee 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 Medical Center Fargo Po Box 2168 Fargo ND 58107-2168 Ph: (701) 234-2119 | Sanford Medical Center Fargo 211 E Mill St Pelican Rapids MN 56572-4234 Ph: (218) 863-6100 |
| NPI Number | 1114953627 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 11/29/2022 |
| Medicare PECOS PAC ID | 8426967803 |
|---|---|
| Medicare Enrollment ID | O20230127000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114953627 | NPI | - | NPPES |
| 517494500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
St. Mary's Regional Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 N Broadway, Pelican Rapids, MN 56572 Phone: 218-863-2000 |