Healthcare Provider Details

I. General information

NPI: 1740621556
Provider Name (Legal Business Name): ALTRU HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 DEMERS AVE
EAST GRAND FORKS MN
56721-1833
US

IV. Provider business mailing address

PO BOX 860939
MINNEAPOLIS MN
55486-0939
US

V. Phone/Fax

Practice location:
  • Phone: 218-773-0357
  • Fax:
Mailing address:
  • Phone: 701-780-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEREK GOEBEL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 701-780-1470