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General NPI Number Information
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NPI Number | 1992528657
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Entity Type | Organization
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Legal Business Name | ALTRU HOSPITAL-DEVILS LAKE
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1031 7TH ST NE
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City | DEVILS LAKE
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State | ND
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Zip | 58301-2719
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Country | US
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Telephone | 701-662-2131
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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 | 58208-3780
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Country | US
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Telephone |
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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 | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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