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General NPI Number Information
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NPI Number | 1689763195
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Entity Type | Organization
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Legal Business Name | ALTRU HEALTH SYSTEM
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 412 MAIN AVE NE
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City | WARROAD
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State | MN
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Zip | 56763-2342
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Country | US
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Telephone | 218-386-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13780
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City | GRAND FORKS
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State | ND
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Zip | 58208-1534
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Country | US
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Telephone | 701-780-5000
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DEREK GOEBEL
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Credential |
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Telephone | 701-780-1470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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