Provider Demographics
NPI:1104210772
Name:ALPINE MEDICAL INC
Entity Type:Organization
Organization Name:ALPINE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-864-1127
Mailing Address - Street 1:400 N PARK AVE 10-B STE 297
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424
Mailing Address - Country:US
Mailing Address - Phone:800-864-1127
Mailing Address - Fax:800-864-1127
Practice Address - Street 1:400 N PARK AVE 10-B STE 297
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424
Practice Address - Country:US
Practice Address - Phone:800-864-1127
Practice Address - Fax:800-864-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSV1074921744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty