NPIMap

Organization Active NPI

Altru Health System

  • Non-Pharmacy Dispensing Site
  • Warroad, MN
National Provider Identifier
1639847502
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
ALTRU HEALTH SYSTEM
Practice address
412 Main Ave NE
Warroad, MN 56763-2342
Phone
(952) 653-2525
Fax
(952) 653-2540
NPI assigned
Sep 3, 2021
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Darla Gunderson
Title
Ao
Phone
(701) 780-5608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

412 Main Ave NE
Warroad, MN 56763-2342

Mailing address

412 Main Ave NE
Warroad, MN 56763-2342
Phone (952) 653-2525

National Provider Directory

National Provider Directory
Tax ID family
Physicians Associates M24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1639847502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 MAIN AVE NE",
            "city": "WARROAD",
            "state": "MN",
            "postal_code": "567632342",
            "telephone_number": "952-653-2525",
            "fax_number": "952-653-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MAIN AVE NE",
            "city": "WARROAD",
            "state": "MN",
            "postal_code": "567632342",
            "telephone_number": "952-653-2525",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTRU HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "GUNDERSON",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "701-780-5608"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warroad, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.