ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC (NPI# 1871829028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871829028 |
| Entity Type | Organization |
| Organization Name | ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC |
| Other Organization Name | ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER |
| Practice Address |
1380 S Columbia Rd Grand Forks ND 58201-4059 |
| Practice Telephone | 7017952020 |
| Practice Fax Number | 7017952019 |
| Mailing Telephone | 7017952020 |
| Mailing Fax Number | 7017952019 |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | KELLY HULST (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7017952020 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHAR959 | ND | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
264525 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1871829028 | 05 | |
| ND | 1457480 | 05 | |
| PK | 2122317 | 01 |
| Other Name | Type Code |
|---|---|
| Altru Clinic Pharmacy - Family Medicine Center | Doing Business As Name - Organization |
| 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 | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1306931977 | B & E Pharmacy Services Inc | Pharmacy | 2015 Library Circle, Grand Forks, ND 58201 | 2006-10-03 |
| 1851481790 | White Drug Company of Jamestown, Inc. | Pharmacy | 1380 S Columbia Rd, Suite 1, Grand Forks, ND 58201-4059 | 2006-10-13 |
| 1376632067 | Walls Altru Pharmacy Inc | Pharmacy | 4440 S Washington St, Ste 101d, Grand Forks, ND 58201-7245 | 2006-10-12 |
| 1962436113 | Grand Forks Clinic Pharmacy | Pharmacy | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1912416876 | Lifescript Pharmacy Pllc | Pharmacy | 5670 38th Ave S Unit A, Fargo, ND 58104-9051 | 2017-09-23 |
| 1205231990 | N D Pharmacy Inc | Pharmacy | 1283 Roughrider Blvd, Dickinson, ND 58601-6780 | 2014-10-24 |
| 1063839496 | G & G Rx Inc | Pharmacy | 1500 14th Street West, Suite 150, Williston, ND 58801-5303 | 2014-03-24 |
| 1962706036 | Inhealth Specialty Pharmacy, Inc. | Pharmacy | 2345 25th St S Ste C, Fargo, ND 58103-6173 | 2011-01-05 |
| 1982826756 | Integrated Health Marketing LLC | Pharmacy | 5675 26th Ave S Ste 136a, Fargo, ND 58104-8975 | 2007-05-02 |
| 1689725434 | Tioga Drug Inc | Pharmacy | 106 N. Main St., Tioga, ND 58852 | 2007-01-16 |
| 1891855326 | Sanger Inc | Pharmacy | 4101 13th Ave S, Fargo, ND 58103-3342 | 2006-12-12 |
| 1457419962 | Johnson Drug Co | Pharmacy | 2522 N Broadway, Fargo, ND 58102 | 2006-12-05 |
| 1881705499 | J Co Drug Inc | Pharmacy | 120 North Main, Crosby, ND 58730 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC.
| 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.