Provider Demographics
NPI:1851805667
Name:SANFORD ABERDEEN MEDICAL CENTER
Entity Type:Organization
Organization Name:SANFORD ABERDEEN MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED OCCUPATIONAL THERAPY ASST
Authorized Official - Prefix:
Authorized Official - First Name:ABBIE
Authorized Official - Middle Name:LINNEA
Authorized Official - Last Name:HAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:605-626-4380
Mailing Address - Street 1:2905 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-5420
Mailing Address - Country:US
Mailing Address - Phone:605-626-4380
Mailing Address - Fax:605-626-4381
Practice Address - Street 1:2905 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-5420
Practice Address - Country:US
Practice Address - Phone:605-626-4380
Practice Address - Fax:605-626-4381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD362A261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine