Provider Demographics
NPI:1407979628
Name:ALASKA CENTER FOR THE BLIND AND VISUALLY IMPAIRED
Entity Type:Organization
Organization Name:ALASKA CENTER FOR THE BLIND AND VISUALLY IMPAIRED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-248-7770
Mailing Address - Street 1:3903 TAFT DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-3069
Mailing Address - Country:US
Mailing Address - Phone:907-248-7770
Mailing Address - Fax:907-248-7517
Practice Address - Street 1:3903 TAFT DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-3069
Practice Address - Country:US
Practice Address - Phone:907-248-7770
Practice Address - Fax:907-248-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOD0047Medicaid
AKMS8817Medicaid
AK152986Medicare PIN
AKMS8817Medicaid
AKOD0047Medicaid