Organization
INNOVIS HEALTH LLC
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health West Acres Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN J HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
3902 13TH AVE S STE 3704, FARGO, ND 58103-7512
(701) 364-6600
(701) 364-6628
Mailing address
PO BOX 1450 NW7813, MINNEAPOLIS, MN 55485-7813
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14510
—
ND
Enumeration date
12/26/2012
Last updated
03/01/2024
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