Provider Demographics
NPI:1871682344
Name:ALTRU HEALTH SYSTEM
Entity Type:Organization
Organization Name:ALTRU HEALTH SYSTEM
Other - Org Name:ALTRU CLINIC - RED LAKE FALLS
Other - Org Type:Doing Business As
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:PO BOX 606
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-0606
Mailing Address - Country:US
Mailing Address - Phone:218-253-4343
Mailing Address - Fax:
Practice Address - Street 1:312 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:RED LAKE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56750-4603
Practice Address - Country:US
Practice Address - Phone:218-253-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center