Provider Demographics
NPI:1518406347
Name:PATIENT HOUSING AT ANMC
Entity Type:Organization
Organization Name:PATIENT HOUSING AT ANMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDERENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-729-2850
Mailing Address - Street 1:4315 DIPLOMACY DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5926
Mailing Address - Country:US
Mailing Address - Phone:907-729-2850
Mailing Address - Fax:907-729-2362
Practice Address - Street 1:4001 TUDOR CENTRE DRIVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5932
Practice Address - Country:US
Practice Address - Phone:907-729-2850
Practice Address - Fax:907-729-2362
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK255468282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital