ALTRU FAMILY MEDICINE CENTER (NPI# 1174662852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174662852 |
Entity Type | Organization |
Organization Name | ALTRU FAMILY MEDICINE CENTER |
Practice Address |
1380 S Columbia Rd Grand Forks ND 58201-4059 |
Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
Practice Telephone | 7017952230 |
Mailing Telephone | 8586252990 |
Mailing Fax Number | 8586252999 |
Enumeration Date | 2007-02-06 |
Last Update Date | 2012-10-16 |
Authorized Official Name | MR. KENNY HEINE (DIRECTOR OF OPERATIONS) |
Authorized Official Telephone | 8586252990 |
Is Organization Subpart | Y |
Parent Organization Name | MEDVANTX, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332900000X | Non-Pharmacy Dispensing Site | 5809 | ND | Suppliers |
Street Address |
1380 S COLUMBIA RD |
City | GRAND FORKS |
State | ND |
Zip Code | 58201-4059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639195357 | Christian R Dequet | Internal Medicine | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2006-07-14 |
1356972665 | Leslie Erica Rodriguez | Nurse Practitioner | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2020-01-27 |
1548812704 | Jennifer Hayes | Physician Assistant | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2019-07-09 |
1922669324 | Megan Price | Social Worker | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2019-06-26 |
1093201402 | Beth Brynjulson | Nurse Practitioner | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2018-07-09 |
1700371952 | Ashley Ann Nephew | Nurse Practitioner | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2018-06-28 |
1366965527 | Kelsey Anne Adams | Nurse Practitioner | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2017-07-19 |
1114466828 | Altru Health System | Clinic/Center | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2017-02-14 |
1417367996 | Joshua Kenneth Sayler | Obstetrics & Gynecology | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2014-05-06 |
1811334030 | Shannon Holsen | Family Medicine | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2013-05-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
Find all providers in zip 58201 |
Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457629834 | Altru Health System | Non-Pharmacy Dispensing Site | 1200 S Columbia Rd, Grand Forks, ND 58201-4036 | 2011-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700444619 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 807 East Main Suite A, Bismarck, ND 58503 | 2019-06-05 |
1437717576 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 921 W Interstate Ave, Bismarck, ND 58503-0955 | 2019-06-04 |
1275675118 | Internal Medicine Associates, Ltd. | Non-Pharmacy Dispensing Site | 1707 Gold Dr S, Suite 101, Fargo, ND 58103-6413 | 2007-02-13 |
1548870520 | Mckenzie County Healthcare Systems Inc | Non-Pharmacy Dispensing Site | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
1538727441 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 4315 Ottawa St, Bismarck, ND 58503 | 2019-06-05 |
1144710658 | Innovis Health, LLC | Non-Pharmacy Dispensing Site | 4110 51st Ave S, Fargo, ND 58104-7776 | 2018-05-10 |
1225433485 | St Josephs Hospital and Health Center | Non-Pharmacy Dispensing Site | 30 7th St W, Dickinson, ND 58601-4335 | 2014-10-30 |
1073867263 | Hans Bjellum Md PC | Non-Pharmacy Dispensing Site | 1100 19th Ave N, Fargo, ND 58102-5906 | 2012-11-09 |
1790060937 | Mercy Medical Center | Non-Pharmacy Dispensing Site | 1301 15th Ave W, Williston, ND 58801-3821 | 2011-10-19 |
1679869697 | Hans Bjellum, Md, PC | Non-Pharmacy Dispensing Site | 4622 40th Ave S, Fargo, ND 58104-4394 | 2011-06-28 |
Find all providers with the same taxonomy |
City | GRAND FORKS |
Zip Code | 58201 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.