Provider Demographics
NPI:1194198747
Name:ALASKA MEDICAL CENTER
Entity Type:Organization
Organization Name:ALASKA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-276-2844
Mailing Address - Street 1:188 W NORTHERN LIGHTS BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3984
Mailing Address - Country:US
Mailing Address - Phone:907-276-2803
Mailing Address - Fax:907-278-8052
Practice Address - Street 1:188 W NORTHERN LIGHTS BLVD STE 800
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3984
Practice Address - Country:US
Practice Address - Phone:907-276-2803
Practice Address - Fax:907-278-8052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical