Provider Demographics
NPI:1588745103
Name:ALPINE PHYSICIANS HEALTH CENTER
Entity type:Organization
Organization Name:ALPINE PHYSICIANS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:406-586-2392
Mailing Address - Street 1:1627 W MAIN ST
Mailing Address - Street 2:SUITE 422
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4011
Mailing Address - Country:US
Mailing Address - Phone:406-586-2392
Mailing Address - Fax:406-586-2879
Practice Address - Street 1:613 W LAMME ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3434
Practice Address - Country:US
Practice Address - Phone:406-586-2392
Practice Address - Fax:406-586-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT79261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center