Provider Demographics
NPI:1598852972
Name:SANFORD HEALTHCARE ACCESSORIES, LLC
Entity Type:Organization
Organization Name:SANFORD HEALTHCARE ACCESSORIES, LLC
Other - Org Name:SANFORD HEALTH EQUIP
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:LEE
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-328-8380
Mailing Address - Street 1:PO BOX 9679
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58106-9679
Mailing Address - Country:US
Mailing Address - Phone:701-234-1337
Mailing Address - Fax:701-234-1366
Practice Address - Street 1:116 1ST ST SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3837
Practice Address - Country:US
Practice Address - Phone:701-852-4110
Practice Address - Fax:701-234-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
17124OtherHEALTHPARTNERS
1043597OtherPREFERRED ONE
141890100OtherFED WORKERS COMP
297G7HEOtherMNBC
MN320402200Medicaid
SD9163333Medicaid
70509OtherNDBC - NUTRITION THERAPY
ND55082Medicaid
7880OtherNDBC
8214538OtherMEDICA
MN320402200Medicaid