Provider Demographics
NPI:1801585823
Name:ALPINE HOME MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:ALPINE HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-590-2714
Mailing Address - Street 1:168 W 1280 N
Mailing Address - Street 2:SUITE E5
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074
Mailing Address - Country:US
Mailing Address - Phone:801-463-0044
Mailing Address - Fax:
Practice Address - Street 1:168 W 1280 N
Practice Address - Street 2:SUITE E5
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074
Practice Address - Country:US
Practice Address - Phone:801-463-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPINE HOME MEDICAL EQUIPMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies