Organization
ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC
Active
Organization
ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC
Active
Other names
Altru Clinic Pharmacy - Family Medicine Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY HULST RPH (PRESIDENT/OWNER)
(701) 795-2020
Entity
Organization
Contact information
Practice address
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2020
(701) 795-2019
Mailing address
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2020
(701) 795-2019
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHAR959
ND
3336C0003X
Community/Retail Pharmacy
Primary
264525
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457480
—
ND
05
—
1871829028
—
MN
01
—
2122317
PK
—
Enumeration date
10/22/2009
Last updated
03/03/2022
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