Provider Demographics
NPI:1770527590
Name:SANFORD HEALTHCARE ACCESSORIES, LLC
Entity type:Organization
Organization Name:SANFORD HEALTHCARE ACCESSORIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:
Practice Address - Street 1:3223 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6297
Practice Address - Country:US
Practice Address - Phone:701-293-8211
Practice Address - Fax:701-234-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
17124OtherHEALTHPARNTERS
ND55082Medicaid
SD9163333Medicaid
MN320402200Medicaid
141890100OtherFED WORKERS COMP
14917OtherSIOUX VALLEY
1043597OtherPREFERRED ONE
297G7HEOtherMNBC
8214531OtherMEDICA
7795OtherNDBC
MN320402200Medicaid