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Suppliers Non-Pharmacy Dispensing Site

Provider NPI: 1588834501

Organization Information:
Organization Name:  SANFORD CLINIC
Organization is not Subpart
Authorized Official:  LAURIE  KUNTSON  DIR OF CLINIC OPER  605-328-8033

Practice Location:
1309 W 17TH ST #101 SIOUX FALLS, SD 57104-4663 US
Tel: 605-328-8000  Fax: 605-328-8054

Business Mailing Address:
1309 W 17TH ST #101 SIOUX FALLS, SD 57104-4663 US
Tel: --  Fax: --

NPI Information:
NPI: 1588834501
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Non-Pharmacy Dispensing Site

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 332900000X





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