Provider Demographics
NPI:1578180352
Name:ALPINE PT HOME CARE, LLC
Entity Type:Organization
Organization Name:ALPINE PT HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:PHILIPP
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-772-2387
Mailing Address - Street 1:1310 BAKER STREET
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3452
Mailing Address - Country:US
Mailing Address - Phone:303-772-2387
Mailing Address - Fax:
Practice Address - Street 1:1310 BAKER STREET
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3452
Practice Address - Country:US
Practice Address - Phone:303-772-2387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty