Organization
ALPINE SUPPLY, LLC
Active
Organization
ALPINE SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP VASTA (OWNER)
(561) 289-9988
Entity
Organization
Contact information
Practice address
2536 PLOVER ROAD, PLOVER, WI 54467-3926
(715) 345-1771
(715) 345-0359
Mailing address
7451 WILES RD STE 105, CORAL SPRINGS, FL 33067-2040
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6544280001
PTAN
WI
Enumeration date
10/13/2010
Last updated
02/22/2019
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