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Organization
ST. MARY'S REGIONAL HEALTH CENTER
Active
Organization
ST. MARY'S REGIONAL HEALTH CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Mary's - Lake Park Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
1005 1ST ST, LAKE PARK, MN 56554-4311
(218) 238-5901
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 238-5901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892442000
—
MN
Enumeration date
04/24/2013
Last updated
03/01/2024
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