Provider Demographics
NPI:1033616891
Name:ALASKA COMMONS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ALASKA COMMONS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAREK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:831-588-7296
Mailing Address - Street 1:6911 DEBARR RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1806
Mailing Address - Country:US
Mailing Address - Phone:831-588-7296
Mailing Address - Fax:
Practice Address - Street 1:6911 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1806
Practice Address - Country:US
Practice Address - Phone:831-588-7296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-09
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty