MEDICARE: ALPINE NURSING CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	251E00000X	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1806808	OTHER	OH	ODMRDD CONTRACT #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518969989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPINE NURSING CARE, INC.

Provider Business Mailing Address
First Line	:	4753 NORTHFIELD RD
Second Line	:	SUITE 5
City	:	NORTH RANDALL
State	:	OH
Zip	:	44128-4539
Country	:	US
Telephone Number	:	216-365-0214
Fax Number	:	216-365-0217

Provider Business Practice Location Address
First Line	:	4753 NORTHFIELD RD
Second Line	:	SUITE 5
City	:	NORTH RANDALL
State	:	OH
Zip	:	44128-4539
Country	:	US
Telephone Number	:	216-365-0214
Fax Number	:	216-365-0217

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	MR. DIVYESH PATEL
Credential	:
Telephone Number	:	216-365-0214

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	12/03/2007

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