Sanford Health Forman Clinic | |
336 Main Street Forman ND 58032-0184 | |
(701) 724-3221 | |
(701) 724-3222 |
Full Name | Sanford Health Forman Clinic |
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Speciality | Clinic/Center |
Location | 336 Main Street, Forman, North Dakota |
Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
Authorized Official Contact | 6053288380 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sanford Health Forman Clinic Po Box 2168 Fargo ND 58107-2168 Ph: (701) 234-2119 | Sanford Health Forman Clinic 336 Main Street Forman ND 58032-0184 Ph: (701) 724-3221 |
NPI Number | 1073520003 |
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Provider Enumeration Date | 08/02/2006 |
Last Update Date | 11/29/2022 |
Medicare PECOS PAC ID | 8426967803 |
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Medicare Enrollment ID | O20221227001238 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073520003 | NPI | - | NPPES |
1331001 | Other | ND | BLUE SHIELD |
12857 | Medicaid | ND | |
5128 | Medicaid | ND | |
CF8850 | Other | ND | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |