Provider Demographics
NPI:1316601990
Name:AUGAFA, PHILLIP F
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:F
Last Name:AUGAFA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 JARVIS AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-4051
Mailing Address - Country:US
Mailing Address - Phone:907-764-1061
Mailing Address - Fax:
Practice Address - Street 1:2140 JARVIS AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-4051
Practice Address - Country:US
Practice Address - Phone:907-764-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101453253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care