Family Medicine Residency Pharmacy

LBN: Altru Health System
Family Medicine Residency Pharmacy is an health care organization with primary practice located at 725 Hamline St , Grand Forks ND 58203-2819. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Altru Health System can be contacted via phone (701) 780-6870, or through Goebel, Derek via phone (701) 780-1470.

Contact Information

Primary practice address
725 Hamline St Grand Forks ND 58203-2819
Phone: (701) 780-6870
Fax: (701) 780-6878
Website:
Map and Directions
Authorized official contact:
Name: Goebel, Derek
Phone: (701) 780-1470

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X PHAR477 North Dakota

Profile Details

NPI number 1144368085
LBN Legal business name Altru Health System
DBA Doing business as Family Medicine Residency Pharmacy
Authorized official Goebel, Derek
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2007
Last updated May 23rd, 2024 - about 4 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144368085 NPPES
North Dakota MEDICAID 21082
North Dakota Other 2071404
North Dakota MEDICAID 574155600

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