Organization · Type 2 NPI

Altru Health System

Clinic/Center · Grand Forks, ND

NPI number 1811617103 Active

Practice location

4401 S 11th St Ste 1000
Grand Forks, ND 58201-7238

Call (701) 780-7620 Map

Mailing address

PO Box 860939
Minneapolis, MN 55486-0939

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in Grand Forks

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NPI record

NPI: 1811617103
Entity type: Organization (Type 2)
Issued: Aug 29, 2022
Last updated: Nov 18, 2025
Status: Active
Subpart: Yes of Altru Health System

Other names

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Sanny and Jerry Ryan Center for Prevention and Genetics · other name
Sanny and Jerry Ryan Center for Prevention and Genetics · other name

Authorized official

Derek Goebel
Chief Financial Officer
(701) 780-1470

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1811617103

Altru Health System's National Provider Identifier is 1811617103, issued on Aug 29, 2022. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Grand Forks, ND. The record was last updated on Nov 18, 2025.