Organization Name: | ALTRU HEALTH SYSTEM |
NPI Number: | 1124117692 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVE MOLMEN (CEO) |
Mailing Address: | 1031 5th Street Devils Lake |
State: | ND US |
Postal Code: | 58301 |
Phone Number: | 7016629670 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 07/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |