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SCH350019-08 ALTRU HOSPITAL (Terminated)
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Main Details
Name
ALTRU HOSPITAL
Subdivision Name
ALTRU CLINIC - CROOKSTON
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH350019-08
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
400 S.MINNESOTA STREET
CROOKSTON, MN 56716
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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