MEDICARE: ALTRU HEALTH SYSTEM

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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1871682344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTRU HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	PO BOX 606
Second Line	:
City	:	CROOKSTON
State	:	MN
Zip	:	56716-0606
Country	:	US
Telephone Number	:	218-253-4343
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 INTERNATIONAL DR
Second Line	:
City	:	RED LAKE FALLS
State	:	MN
Zip	:	56750-4603
Country	:	US
Telephone Number	:	218-253-4343
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DOUGLAS ARVIN
Credential	:
Telephone Number	:	701-780-5000

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/31/2022

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