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SCH350019-06 ALTRU HOSPITAL (Terminated)
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Main Details
Name
ALTRU HOSPITAL
Subdivision Name
TRUYU AESTHETIC CENTER
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH350019-06
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
8/5/2010
Last Recertification Date
9/11/2020
Termination Date
Termination Reason
7/1/2021
Other
Contacts
Authorizing Official
Altru Health System
Janice Hamscher, Chief Nursing Officer
(701) 780-3403
Primary Contact
Altru Health System
Daniel W Oakland, Ancillary Pharmacy Supervisor
(701) 732-7163
Addresses
Street Address
3165 DEMERS AVE.
GRAND FORKS, ND 58201
Billing Address
ALTRU HOSPITAL
PO BOX 13780
GRAND FORKS, ND 58208-3780
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/23/12 - Updated Subdiv name( was TRUYU AESTHETIC)
01/23/2012
April 2025
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