Provider Demographics
NPI:1003012659
Name:LYNN E AND DELAMOUR R. KRILEY
Entity Type:Organization
Organization Name:LYNN E AND DELAMOUR R. KRILEY
Other - Org Name:HEARING CENTER OF FAIRBANKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:F
Authorized Official - Last Name:COURIER
Authorized Official - Suffix:
Authorized Official - Credentials:AAS-HIS
Authorized Official - Phone:907-456-7700
Mailing Address - Street 1:3115 AIRPORT WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4755
Mailing Address - Country:US
Mailing Address - Phone:907-456-7700
Mailing Address - Fax:907-456-7701
Practice Address - Street 1:3115 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4755
Practice Address - Country:US
Practice Address - Phone:907-456-7700
Practice Address - Fax:907-456-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK67332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies