Provider Demographics
NPI:1447948260
Name:ALPINE COMPOUNDING PHARMACY, INC
Entity type:Organization
Organization Name:ALPINE COMPOUNDING PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:UKHNOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CHPT
Authorized Official - Phone:720-883-6095
Mailing Address - Street 1:10386 RALSTON RD
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-5860
Mailing Address - Country:US
Mailing Address - Phone:720-883-6095
Mailing Address - Fax:720-716-3748
Practice Address - Street 1:10386 RALSTON RD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-5860
Practice Address - Country:US
Practice Address - Phone:720-883-6095
Practice Address - Fax:720-716-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy