Provider Demographics
NPI:1144645581
Name:ALPINE HOME MEDICAL LLC
Entity type:Organization
Organization Name:ALPINE HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROTEFEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-421-3040
Mailing Address - Street 1:1900 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-5272
Mailing Address - Country:US
Mailing Address - Phone:715-421-3040
Mailing Address - Fax:715-421-3040
Practice Address - Street 1:1900 8TH ST S
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-5272
Practice Address - Country:US
Practice Address - Phone:715-421-3040
Practice Address - Fax:715-421-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies