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General NPI Number Information
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NPI Number | 1104210772
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Entity Type | Organization
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Legal Business Name | ALPINE MEDICAL INC
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 400 N PARK AVE 10-B STE 297
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City | BRECKENRIDGE
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State | CO
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Zip | 80424
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Country | US
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Telephone | 800-864-1127
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Fax | 800-864-1127
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Provider Business Mailing Address
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Address Line | 400 N PARK AVE 10-B STE 297
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City | BRECKENRIDGE
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State | CO
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Zip | 80424
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Country | US
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Telephone | 800-864-1127
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Fax | 800-864-1127
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Authorized Official
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Title or Position | COO
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Name | DR. JOSEPH CARUSSO
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Credential |
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Telephone | 800-864-1127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | SV107492
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License Number State | CO
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