Provider Demographics
NPI:1083189203
Name:ALTRU HEALTH SYSTEM
Entity Type:Organization
Organization Name:ALTRU HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-780-5000
Mailing Address - Street 1:23076 347TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ERSKINE
Mailing Address - State:MN
Mailing Address - Zip Code:56535-9466
Mailing Address - Country:US
Mailing Address - Phone:952-653-2565
Mailing Address - Fax:952-653-2540
Practice Address - Street 1:23076 347TH STREET SE
Practice Address - Street 2:
Practice Address - City:ERSKINE
Practice Address - State:MN
Practice Address - Zip Code:56535-9466
Practice Address - Country:US
Practice Address - Phone:952-653-2565
Practice Address - Fax:952-653-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2022-08-31
Deactivation Date:2019-08-07
Deactivation Code:
Reactivation Date:2019-11-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty