Organization · Type 2 NPI

Sanford Medical Center Fargo

Rural Health Clinic/Center · Forman, ND

NPI number 1073520003 Active

Practice location

336 Main Street
Forman, ND 58032-0184

Call (701) 724-3221 Map

Fax (701) 724-3222

Mailing address

PO Box 2168
Fargo, ND 58107-2168

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

Another provider at this address

Southeast Therapy Services IncPhysical Therapy Clinic/Center Forman, ND NPI 1013926005

NPI record

NPI: 1073520003
Entity type: Organization (Type 2)
Issued: Aug 2, 2006
Last updated: Nov 29, 2022
Status: Active

Other names

<unavail>
Sanford Health Forman Clinic · doing business as
Sanford Health Forman Clinic · doing business as

Authorized official

Tony Lee Morrison
Vice President, Revenue Cycle
(605) 328-8380

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073520003

Sanford Medical Center Fargo's National Provider Identifier is 1073520003, issued on Aug 2, 2006. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Forman, ND. The record was last updated on Nov 29, 2022.