Provider Demographics
NPI:1083965966
Name:AAA ALASKA CAB, INC.
Entity Type:Organization
Organization Name:AAA ALASKA CAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-262-5050
Mailing Address - Street 1:PO BOX 1306
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-1306
Mailing Address - Country:US
Mailing Address - Phone:907-262-5050
Mailing Address - Fax:907-262-9550
Practice Address - Street 1:47623 WEST POINT AVE
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-9772
Practice Address - Country:US
Practice Address - Phone:907-262-5050
Practice Address - Fax:907-262-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK150136344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHC5354Medicaid
AKTX1174Medicaid