Essentia Health South University Clinic | |
1702 University Dr S Fargo ND 58103-4940 | |
(701) 364-3300 | |
(701) 364-8906 |
Full Name | Essentia Health South University Clinic |
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Speciality | Family Medicine |
Location | 1702 University Dr S, Fargo, North Dakota |
Authorized Official Name and Position | Alan J Hurley (COO) |
Authorized Official Contact | 7013647667 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Essentia Health South University Clinic Po Box 1450 Nw7813 Minneapolis MN 55485-7813 Ph: (701) 364-3300 | Essentia Health South University Clinic 1702 University Dr S Fargo ND 58103-4940 Ph: (701) 364-3300 |
NPI Number | 1255677084 |
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Provider Enumeration Date | 12/26/2012 |
Last Update Date | 03/01/2024 |
Medicare PECOS PAC ID | 9931298155 |
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Medicare Enrollment ID | O20130710000832 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255677084 | NPI | - | NPPES |
14510 | Medicaid | ND |
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