Organization
ST. MARY'S REGIONAL HEALTH CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Mary's - Mahnomen 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
117 N MAIN ST, MAHNOMEN, MN 56557-4003
(218) 936-5616
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892442000
—
MN
Enumeration date
04/23/2013
Last updated
03/01/2024
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