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Contact Information

ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC
1380 S COLUMBIA RD
GRAND FORKS, ND58201-4059
 Phone: 701-795-2020
 Fax: 701-795-2019
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC

NPI Number 1871829028
LBN Legal business name ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC
Authorized official KELLY HULST - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/22/2009
Last updated 03/03/2022 - About 4 years ago
Identifiers
MN License # 264525
ND License # PHAR959
MN Medicaid 1871829028
ND Medicaid 1457480
Other 2122317 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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