ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER
NPI 1871829028
Pharmacy - Community/Retail Pharmacy in Grand Forks, ND

Q: What is Altru Clinic Pharmacy - Family Medicine Center Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since October 22, 2009CLIA 35D2317372 · Microscopy

1380 S COLUMBIA RD, GRAND FORKS, ND 58201(701) 795-2020(701) 795-2019 Get Directions Write a Review

NPPES record last updated: March 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 3, 2022, Mar 29, 2017 (2 updates tracked since 2017).

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About Altru Clinic Pharmacy - Family Medicine Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER (NPI 1871829028) is a healthcare organization registered as a community/retail pharmacy in Grand Forks, North Dakota and active in the NPI registry since October 2009. The organization holds a CLIA Microscopy certificate valid through January 22, 2027 and lists Kelly Hulst, President/owner, as its authorized official.

NPPES Registry Identity

NPI1871829028

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameALTRU CLINIC PHARMACY - FAMILY MEDICINE CENTER INC

Location Address1380 S COLUMBIA RDGrand Forks, ND 58201-4059

Mailing Address1380 S Columbia RdGrand Forks, ND 58201-4059 · (701) 795-2020 · Fax (701) 795-2019

Phone(701) 795-2020

Fax(701) 795-2019

Organization SubpartNo

Authorized OfficialKelly HulstPresident/owner · (701) 795-2020

Enumeration DateOctober 22, 2009

Last NPPES UpdateMarch 3, 20222 updates tracked since enumeration

NPPES CertifiedMarch 3, 2022

✔ NPI 1871829028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MN · 264525

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedPharmacyTaxonomy 333600000X · License PHAR959 (ND)

Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X

1380 S COLUMBIA RD, Grand Forks, ND 58201

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Other Names 1

Doing Business AsAltru Clinic Pharmacy - Family Medicine Center

Other Identifiers 3

Other2122317Pk

Medicaid1457480ND

Medicaid1871829028MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 35D2317372

Altru Clinic · Grand Forks, ND

Active · expires Jan 22, 2027

CLIA Number35D2317372

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateJanuary 23, 2025

Certificate Expiration DateJanuary 22, 2027

Laboratory DirectorYan Xia

Laboratory Phone(701) 780-5133

Laboratory LocationAltru Clinic1300 S Columbia Rd, Grand Forks, ND 58201

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Altru Clinic Pharmacy-Family Medici carries, from the Medicare DMEPOS supplier directory.

Altru Clinic Pharmacy-Family Medici

DMEPOS supplier · Grand Forks, NDOperated by Altru Clinic Pharmacy - Family Medicine Center Inc

✔

Accepts Medicare assignment

Altru Clinic Pharmacy-Family Medici agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20546231

Medicare Participant SinceJanuary 25, 2010

Supplier Location1380 S Columbia RdGrand Forks, ND 58201

Phone(701) 795-2020

Supplier Specialties

Pharmacy

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA HUSS-GACKLE NP

Nurse Practitioner