| Sanford Health Network | |
|
110 5th Ave Ipswich SD 57451-2038 | |
| (605) 426-6040 | |
| (605) 426-6043 |
| Full Name | Sanford Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 5th Ave, Ipswich, South Dakota |
| 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 Health Network Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Health Network 110 5th Ave Ipswich SD 57451-2038 Ph: (605) 426-6040 |
| NPI Number | 1962459842 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 01/23/2025 |
| Medicare PECOS PAC ID | 6800707100 |
|---|---|
| Medicare Enrollment ID | O20131112000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962459842 | NPI | - | NPPES |
| 5300910 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Avera St. Luke's Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Bloemendaal Drive, Ipswich, SD 57451 Phone: 605-622-2857 Fax: 605-622-2859 |