Organization
ALPINE MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY L. FENN (PRESIDENT)
(715) 345-1771
Entity
Organization
Contact information
Practice address
2536 PLOVER RD, SUITE 1, PLOVER, WI 54467-3913
(715) 345-1771
(715) 345-0359
Mailing address
1602 BRENDA DR, PLOVER, WI 54467-2315
(715) 345-1771
(715) 345-0359
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41729500
—
WI
Enumeration date
01/05/2006
Last updated
12/04/2007
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