Provider Demographics
NPI:1598185597
Name:SANFORD BISMARCK
Entity Type:Organization
Organization Name:SANFORD BISMARCK
Other - Org Name:SANFORD HEALTH SAME DAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-328-9501
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:605-328-6512
Practice Address - Street 1:2615 FAIRWAY STREET
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601
Practice Address - Country:US
Practice Address - Phone:701-456-6000
Practice Address - Fax:701-456-6192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANFORD BISMARCK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND8419OtherJOINT COMMISSION
ND5454OtherAAAASF
ND35C0001025Medicare Oscar/Certification