Provider Demographics
NPI:1982945820
Name:ALTERNACARE, INC
Entity Type:Organization
Organization Name:ALTERNACARE, INC
Other - Org Name:ALPINE MEDICAL SUPPLY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-260-7088
Mailing Address - Street 1:3404 W OKMULGEE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-5071
Mailing Address - Country:US
Mailing Address - Phone:918-682-7773
Mailing Address - Fax:918-682-0496
Practice Address - Street 1:1601 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4451
Practice Address - Country:US
Practice Address - Phone:918-686-1037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNACARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-01
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK6729470003Medicare NSC