Provider Demographics
NPI:1114086311
Name:SANFORD HEALTH NETWORK
Entity Type:Organization
Organization Name:SANFORD HEALTH NETWORK
Other - Org Name:SANFORD HEALTH NETWORK
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-328-8380
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:507-662-5893
Practice Address - Street 1:209 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAKEFIELD
Practice Address - State:MN
Practice Address - Zip Code:56150
Practice Address - Country:US
Practice Address - Phone:507-662-6611
Practice Address - Fax:507-662-5893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCN5082Medicare PIN
MNC02532Medicare PIN
MN243403AMedicare Oscar/Certification
MN0403210006Medicare NSC