Provider Demographics
NPI:1407928898
Name:CITY OF ANDERSON
Entity Type:Organization
Organization Name:CITY OF ANDERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-582-2500
Mailing Address - Street 1:PO BOX 3100
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:AK
Mailing Address - Zip Code:99744-3100
Mailing Address - Country:US
Mailing Address - Phone:907-582-2500
Mailing Address - Fax:907-582-2496
Practice Address - Street 1:260 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:AK
Practice Address - Zip Code:99744-9800
Practice Address - Country:US
Practice Address - Phone:907-582-2500
Practice Address - Fax:907-582-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1004275Medicaid
AK1004275Medicaid