Provider Demographics
NPI:1407025307
Name:FRONTIER GROUP, INC.
Entity Type:Organization
Organization Name:FRONTIER GROUP, INC.
Other - Org Name:FRONTIER MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:907-258-8618
Mailing Address - Street 1:907 E DOWLING RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1424
Mailing Address - Country:US
Mailing Address - Phone:907-258-8618
Mailing Address - Fax:
Practice Address - Street 1:165 SHADY LN
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7519
Practice Address - Country:US
Practice Address - Phone:907-260-8618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1021442Medicaid
AK1270320002OtherPTAN