Healthcare Provider Details

I. General information

NPI: 1588851091
Provider Name (Legal Business Name): ALPINE MEDICAL SUPPLY & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MAGAZINE ST STE 103
SAULT SAINTE MARIE MI
49783-1867
US

IV. Provider business mailing address

PO BOX 478
KALKASKA MI
49646-0478
US

V. Phone/Fax

Practice location:
  • Phone: 906-632-4400
  • Fax: 231-258-8204
Mailing address:
  • Phone: 231-258-8200
  • Fax: 231-258-8204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateMI

VIII. Authorized Official

Name: MRS. DONNA L WHITENIGHT
Title or Position: OFFICE MANAGER
Credential:
Phone: 231-258-8200