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NPI Code Detail

MEDICARE: ALTRU SPECIALTY SERVICES, INC.

MEDICARE: ALTRU SPECIALTY SERVICES, INC.
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1780773259
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTRU SPECIALTY SERVICES, INC.
Provider Business Mailing Address
First Line : 1200 SOUTH COLUMBIA ROAD
Second Line :
City : GRAND FORKS
State : ND
Zip : 58206
Country : US
Telephone Number : 701-780-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S COLUMBIA RD
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-4012
Country : US
Telephone Number : 701-780-5000
Fax Number :
Authorized Official
Title or Position : CEO
Name : DAVE MOLMEN
Credential :
Telephone Number : 701-780-5000
Provider Enumeration Date : 10/12/2006
Last Update Date : 09/14/2010

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