INNOVIS HEALTH - SOUTH UNIVERSITY
NPI 1083756142
Non-Pharmacy Dispensing Site in Fargo, ND

Q: What is Innovis Health's NPI number?

The NPI number for Innovis Health is 1083756142. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Innovis Health - South University.

Q: What is Innovis Health's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Q: When was this NPI record last updated?

The NPPES record for Innovis Health was last updated on October 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 13, 2007

1702 UNIVERSITY DR S, FARGO, ND 58103(701) 364-3300 Get Directions Write a Review

NPPES record last updated: October 16, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Innovis Health - South University NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVIS HEALTH - SOUTH UNIVERSITY (NPI 1083756142) is a healthcare organization registered as a non-pharmacy dispensing site in Fargo, North Dakota and active in the NPI registry since February 2007. The organization lists Kenny Heine, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1083756142

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameINNOVIS HEALTH

Location Address1702 UNIVERSITY DR SFargo, ND 58103-4940

Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705 · (858) 625-2990

Phone(701) 364-3300

Organization SubpartYesParent: Medvantx, Inc.

Authorized OfficialKenny HeineDirector Of Operations · (858) 625-2990

Enumeration DateFebruary 13, 2007

Last NPPES UpdateOctober 16, 2012

✔ NPI 1083756142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

License✔ Licensed in ND · 5109

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

1702 UNIVERSITY DR S, Fargo, ND 58103

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Other Names 1

Doing Business AsInnovis Health - South University

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BANGALORE S VIJAYALAKSHMI MD

Physical Medicine & Rehabilitation