340B Drug Pricing Program Database
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DSH350011HE SANFORD MEDICAL CENTER FARGO (Active)
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Main Details
Name
SANFORD MEDICAL CENTER FARGO
Subdivision Name
Sanford Dialysis Morris 1200.42291 1500100504 - Sanford Dialysis Morris 1200.42291 1500100504
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH350011HE
Medicare Provider Number
350011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/9/2021
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Sanford Medical Center Fargo
Kristin Herrmann, Vice President, Finance
(701) 417-2326
Primary Contact
Sanford Health
Jesse Breidenbach, Vice President, Pharmacy
(701) 234-6887
Addresses
Street Address
400 First Street East
Morris, MN 56267-1408
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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