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DSH350015DQ SANFORD BISMARCK (Active)
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Main Details
Name
SANFORD BISMARCK
Subdivision Name
Sanford West Dickinson Internal Medicine - Sanford West Dickinson Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH350015DQ
Medicare Provider Number
350015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/25/2024
Last Recertification Date
Contacts
Authorizing Official
Sanford Bismarck
Leigh Ann Thompson, Chief Financial Officer
(701) 323-6720
Primary Contact
Sanford Bismarck
John Savageau, Director - Pharmacy
(701) 323-6186
Addresses
Street Address
2615 Fairway Street
Dickinson, ND 58601
Billing Address
Sanford Bismarck
300 North 7th St
Bismarck, ND 58501
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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