Healthcare Provider Details
I. General information
NPI: 1740475847
Provider Name (Legal Business Name): ALTRU HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2007
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 S COLUMBIA RD
GRAND FORKS ND
58201-4012
US
IV. Provider business mailing address
1300 SOUTH COLUMBIA ROAD
GRAND FORKS ND
58206-6002
US
V. Phone/Fax
- Phone: 701-780-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273Y00000X |
| Taxonomy | Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DOUGLAS
ARVIN
Title or Position: CFO
Credential:
Phone: 701-780-5000