Provider Demographics
NPI:1477844975
Name:ALTERNAMED, LLC
Entity Type:Organization
Organization Name:ALTERNAMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DUZICK
Authorized Official - Last Name:KEPNER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:570-875-2308
Mailing Address - Street 1:913 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-1243
Mailing Address - Country:US
Mailing Address - Phone:570-875-2308
Mailing Address - Fax:570-875-3721
Practice Address - Street 1:913 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1243
Practice Address - Country:US
Practice Address - Phone:570-875-2308
Practice Address - Fax:570-875-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1235132176OtherGROUP NPI
PA1014256260002Medicaid