Provider Demographics
NPI:1245519081
Name:SANFORD MEDICAL CENTER FARGO
Entity type:Organization
Organization Name:SANFORD MEDICAL CENTER FARGO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-234-6849
Mailing Address - Street 1:720 4TH ST N
Mailing Address - Street 2:PO BOX 2010
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58122-0605
Mailing Address - Country:US
Mailing Address - Phone:701-234-2000
Mailing Address - Fax:
Practice Address - Street 1:2990 SETER PARKWAY
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8750
Practice Address - Country:US
Practice Address - Phone:701-234-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital