NPIMap

Organization Active NPI

Sanford Clinic North

Doing business as Sanford Pharmacy Broadway 340B

  • Pharmacy
  • Fargo, ND
National Provider Identifier
1053913970
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SANFORD CLINIC NORTH
Doing business as
Sanford Pharmacy Broadway 340B
Practice address
737 Broadway N
Fargo, ND 58102-4421
Phone
(701) 234-2416
Fax
(701) 234-7476
NPI assigned
Nov 16, 2020
Last updated
Nov 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SANFORD CLINIC NORTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

737 Broadway N
Fargo, ND 58102-4421

Mailing address

737 Broadway N
Fargo, ND 58102-4421
Phone (701) 234-2416

Other names 1

  • Sanford Pharmacy Broadway 340B Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sanford Clinic North31 organizations share this tax ID, including this one
Part of
Sanford Clinic North

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1053913970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024421",
            "telephone_number": "701-234-2416",
            "fax_number": "701-234-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024421",
            "telephone_number": "701-234-2416",
            "fax_number": "701-234-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC NORTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANFORD CLINIC NORTH",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Pharmacy Broadway 340B",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.