Provider Demographics
NPI:1407107808
Name:SANFORD MEDICAL CENTER
Entity Type:Organization
Organization Name:SANFORD MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAHN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:605-328-1860
Mailing Address - Street 1:1210 W 18TH ST
Mailing Address - Street 2:SUITE LLO1
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4647
Mailing Address - Country:US
Mailing Address - Phone:605-328-1860
Mailing Address - Fax:605-328-1857
Practice Address - Street 1:1210 W 18TH ST
Practice Address - Street 2:SUITE LLO1
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4647
Practice Address - Country:US
Practice Address - Phone:605-328-1860
Practice Address - Fax:605-328-1857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1406282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital