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General NPI Number Information
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NPI Number | 1992714877
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Entity Type | Organization
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Legal Business Name | ALTRU SPECIALTY SERVICES, INC.
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 1001 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 | 701-662-2158
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Fax |
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Provider Business Mailing Address
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Address Line | 1380 SOUTH COLUMBIA ROAD PO BOX 6011
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City | GRAND FORKS
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State | ND
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Zip | 58201
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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 | EXECUTIVE DIRECTOR
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Name | JODY ANDERSON
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Credential |
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Telephone | 701-780-1542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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