Essentia Health South University Clinic
LBN: Innovis Health Llc
Essentia Health South University Clinic is an health care organization with primary practice located at 1702 University Dr S , Fargo ND 58103-4940. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Dental, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Innovis Health Llc can be contacted via phone (701) 364-3300, or through Hurley, Alan J via phone (701) 364-7667.
Contact Information
Primary practice address
1702 University Dr S
Fargo ND 58103-4940
Phone: (701) 364-3300
Fax: (701) 364-8906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Dental | 261QD0000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1255677084 |
|---|---|
| LBN Legal business name | Innovis Health Llc |
| DBA Doing business as | Essentia Health South University Clinic |
| Authorized official | Hurley, Alan J |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Dec 26th, 2012 |
| Last updated | Mar 1st, 2024 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255677084 | NPPES |
| North Dakota | MEDICAID | 14510 |
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