Healthcare Provider Details

I. General information

NPI: 1942510185
Provider Name (Legal Business Name): ALTRU HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH COLUMBIA ROAD
GRAND FORKS ND
58206-6002
US

IV. Provider business mailing address

1000 SOUTH COLUMBIA ROAD
GRAND FORKS ND
58206-6002
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-5340
  • Fax:
Mailing address:
  • Phone: 701-780-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number1158
License Number StateND

VIII. Authorized Official

Name: HEATHER STRRANDEL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 701-780-5340