Provider Demographics
NPI:1154511657
Name:CIRCLE CLINIC
Entity Type:Organization
Organization Name:CIRCLE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPMS BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-662-2460
Mailing Address - Street 1:P.O. BOX 209
Mailing Address - Street 2:
Mailing Address - City:CIRCLE
Mailing Address - State:AK
Mailing Address - Zip Code:99733-0209
Mailing Address - Country:US
Mailing Address - Phone:907-773-7425
Mailing Address - Fax:907-773-7425
Practice Address - Street 1:209 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CIRCLE
Practice Address - State:AK
Practice Address - Zip Code:99733-0209
Practice Address - Country:US
Practice Address - Phone:907-773-7425
Practice Address - Fax:907-773-7425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center