Provider Demographics
NPI:1386661270
Name:KENAI PENINSULA BOROUGH
Entity Type:Organization
Organization Name:KENAI PENINSULA BOROUGH
Other - Org Name:CENTRAL EMERGENCY SERVICES, NIKISKI FIRE, BEAR CREEK FIRE, KACHEMAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL PLANNING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:FRIEDERSDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-714-2194
Mailing Address - Street 1:144 N BINKLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7520
Mailing Address - Country:US
Mailing Address - Phone:907-714-2194
Mailing Address - Fax:907-714-2376
Practice Address - Street 1:144 N BINKLEY ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7520
Practice Address - Country:US
Practice Address - Phone:907-262-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK00903416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKGA00901Medicaid
AKGA0090Medicaid
AKGA0090Medicaid
AK590006499Medicare ID - Type UnspecifiedRAILROAD MEDICARE