Organization
INNOVIS HEALTH LLC
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health 52nd Avenue 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
4110 51ST AVE S, FARGO, ND 58104-7776
(701) 364-3100
(701) 364-3160
Mailing address
PO BOX 1450 NW7813, MINNEAPOLIS, MN 55485-7813
(701) 364-3100
(701) 364-3160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2016
Last updated
03/01/2024
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