| NPI | 1235173519 |
|---|---|
| Doing Business As | SANFORD PHARMACY BROADWAY |
| Doing Business As | SANFORD PHARMACY ROGER MARIS |
| Entity Type | Organization |
| Authorized Contact | TONY LEE MORRISON Vice President, Revenue Cycle 605-328-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ND 309) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ND 309) |
| 333600000X Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: ND 309) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2023-06-15 |