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SCH350019-02 ALTRU HOSPITAL (Terminated)
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Main Details
Name
ALTRU HOSPITAL
Subdivision Name
Altru 860 Columbia
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH350019-02
Medicare Provider Number
350019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/4/2010
Participating Start Date
8/5/2010
Participating Approval Date
8/4/2010
Last Recertification Date
8/27/2018
Termination Date
Termination Reason
1/1/2019
Other
Contacts
Authorizing Official
Altru Health System
Janice Hamscher, Chief Nursing Officer
(701) 780-3403
Primary Contact
Altru Health System
Cherri Ellis, Supervisor, Budgeting & Cost Accounting
(701) 780-5724
Addresses
Street Address
860 S. COLUMBIA ROAD
GRAND FORKS, ND 58201
Billing Address
ALTRU HOSPITAL
PO BOX 13780
GRAND FORKS, ND 58201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/23/12 - updated Subdiv name(was ALTRU CLINIC-BUILDING 1)
01/23/2012
April 2025
April 2025
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