Provider Demographics
NPI:1467974428
Name:ALPINE MEDICAL
Entity Type:Organization
Organization Name:ALPINE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-899-3733
Mailing Address - Street 1:3100 BIG HORN AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9250
Mailing Address - Country:US
Mailing Address - Phone:307-899-3733
Mailing Address - Fax:307-586-4221
Practice Address - Street 1:902 BIG HORN AVE
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-2705
Practice Address - Country:US
Practice Address - Phone:307-347-3344
Practice Address - Fax:307-347-3341
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPINE MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-12
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies