Healthcare Provider Details

I. General information

NPI: 1114932969
Provider Name (Legal Business Name): ALPINE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1970 S 200 E
SALT LAKE CITY UT
84115-2402
US

IV. Provider business mailing address

PO BOX 65788
SALT LAKE CITY UT
84165-0788
US

V. Phone/Fax

Practice location:
  • Phone: 801-486-2348
  • Fax: 801-466-8961
Mailing address:
  • Phone: 801-486-2348
  • Fax: 801-466-8961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT H BREINHOLT
Title or Position: MEMBER
Credential:
Phone: 801-486-2348