Provider Demographics
NPI:1518033281
Name:ALASKA FAMILY SONOGRAMS, INC
Entity Type:Organization
Organization Name:ALASKA FAMILY SONOGRAMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY-TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-BOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-561-3601
Mailing Address - Street 1:3600 LAKE OTIS PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5225
Mailing Address - Country:US
Mailing Address - Phone:907-561-3601
Mailing Address - Fax:907-561-3900
Practice Address - Street 1:3600 LAKE OTIS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5225
Practice Address - Country:US
Practice Address - Phone:907-561-3601
Practice Address - Fax:907-561-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD6068Medicaid
AKK151293Medicare ID - Type Unspecified