Provider Demographics
NPI:1932547023
Name:ALTRU SPECIALTY SERVICES, INC
Entity Type:Organization
Organization Name:ALTRU SPECIALTY SERVICES, INC
Other - Org Name:YORHOM MEDICAL ESSENTIALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-780-1542
Mailing Address - Street 1:1200 S COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4036
Mailing Address - Country:US
Mailing Address - Phone:701-780-2500
Mailing Address - Fax:701-780-4395
Practice Address - Street 1:4350 S WASHINGTON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7184
Practice Address - Country:US
Practice Address - Phone:701-780-2436
Practice Address - Fax:701-780-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0253720006Medicare Oscar/Certification