Basic Information
| Provider Information | |||||||||
| NPI: | 1689084360 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALPINE MEDICAL | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 BIG HORN AVE | ||||||||
| Address2: | |||||||||
| City: | CODY | ||||||||
| State: | WY | ||||||||
| PostalCode: | 824149250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3078993733 | ||||||||
| FaxNumber: | 3075872365 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 BIG HORN AVE | ||||||||
| Address2: | |||||||||
| City: | CODY | ||||||||
| State: | WY | ||||||||
| PostalCode: | 824149250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3078993733 | ||||||||
| FaxNumber: | 3075872365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2014 | ||||||||
| LastUpdateDate: | 01/10/2019 | ||||||||
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| AuthorizedOfficialLastName: | NEWTON | ||||||||
| AuthorizedOfficialFirstName: | BONNIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3078993733 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.