Healthcare Provider Details

I. General information

NPI: 1992714877
Provider Name (Legal Business Name): ALTRU SPECIALTY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 7TH ST NE
DEVILS LAKE ND
58301-2719
US

IV. Provider business mailing address

1380 SOUTH COLUMBIA ROAD PO BOX 6011
GRAND FORKS ND
58201
US

V. Phone/Fax

Practice location:
  • Phone: 701-662-2158
  • Fax:
Mailing address:
  • Phone: 701-780-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JODY ANDERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 701-780-1542