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NPI Code Detail

MEDICARE: ALTRU HEALTH SYSTEM

MEDICARE: ALTRU HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1053936583
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTRU HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 13780
Second Line :
City : GRAND FORKS
State : ND
Zip : 58208-3780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1006 GREENWOOD ST E
Second Line :
City : THIEF RIVER FALLS
State : MN
Zip : 56701-4120
Country : US
Telephone Number : 218-681-1685
Fax Number :
Authorized Official
Title or Position : CFO
Name : DOUGLAS ARVIN
Credential :
Telephone Number : 701-780-5000
Provider Enumeration Date : 06/10/2020
Last Update Date : 08/18/2021

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Directions to “ALTRU HEALTH SYSTEM ” Practice Location

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