Provider Demographics
NPI:1396975603
Name:ALPINE MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:ALPINE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MATEER
Authorized Official - Suffix:SR
Authorized Official - Credentials:ATP
Authorized Official - Phone:715-316-0056
Mailing Address - Street 1:1011 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:ABBOTSFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54405-9647
Mailing Address - Country:US
Mailing Address - Phone:715-316-0056
Mailing Address - Fax:715-316-0076
Practice Address - Street 1:1011 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:ABBOTSFORD
Practice Address - State:WI
Practice Address - Zip Code:54405
Practice Address - Country:US
Practice Address - Phone:715-316-0056
Practice Address - Fax:715-316-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6386870001Medicare NSC