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NPI Code Detail

MEDICARE: INNOVIS HEALTH, LLC

MEDICARE: INNOVIS HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962682617
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNOVIS HEALTH, LLC
Provider Business Mailing Address
First Line : 132 4TH AVE NE
Second Line :
City : VALLEY CITY
State : ND
Zip : 58072-3056
Country : US
Telephone Number : 701-253-5300
Fax Number : 701-253-5402
Provider Business Practice Location Address
First Line : 132 4TH AVE NE
Second Line :
City : VALLEY CITY
State : ND
Zip : 58072-3056
Country : US
Telephone Number : 701-845-8060
Fax Number : 701-845-8067
Authorized Official
Title or Position : COO
Name : ALAN J HURLEY
Credential :
Telephone Number : 701-364-7667
Provider Enumeration Date : 11/10/2007
Last Update Date : 03/01/2024

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Directions to “INNOVIS HEALTH, LLC ” Practice Location

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