FAMILY MEDICINE RESIDENCY PHARMACY – NPI #1144368085
Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

FAMILY MEDICINE RESIDENCY PHARMACY is a pharmacy located in GRAND FORKS, ND. NPPES has assigned the NPI number 1144368085 to FAMILY MEDICINE RESIDENCY PHARMACY on February 02, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FAMILY MEDICINE RESIDENCY PHARMACY” is a dba name, the actual legal business name for this organization is ALTRU HEALTH SYSTEM. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0002X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Clinic Pharmacy

The NPI profile was previously updated about 2 years ago on May 23, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FAMILY MEDICINE RESIDENCY PHARMACY below.

NPI Profile for
ALTRU HEALTH SYSTEM

NPI Number
1144368085
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ALTRU HEALTH SYSTEM
Doing Business As (dba): FAMILY MEDICINE RESIDENCY PHARMACY
Primary location
725 HAMLINE ST
GRAND FORKS, ND 58203-2819
Phone: (701) 780-6870 Fax: (701) 780-6878
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DEREK GOEBEL
CHIEF FINANCIAL OFFICER
Phone: (701) 780-1470
Updated
Certification Date
May 23, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for FAMILY MEDICINE RESIDENCY PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherPK2071404
medicaidMN574155600
medicaidND21082
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0002X
- Pharmacy / Clinic Pharmacy (Primary)
ND PHAR477
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.