Provider Demographics
NPI:1053487025
Name:CITY & BOROUGH OF JUNEAU ALASKA
Entity Type:Organization
Organization Name:CITY & BOROUGH OF JUNEAU ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-586-0375
Mailing Address - Street 1:155 S SEWARD ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1332
Mailing Address - Country:US
Mailing Address - Phone:907-586-0375
Mailing Address - Fax:907-586-5367
Practice Address - Street 1:610 S BAILEY ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6330
Practice Address - Country:US
Practice Address - Phone:907-745-0268
Practice Address - Fax:907-745-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKTR03223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKTR0322Medicaid
AKK161696Medicare PIN