Provider Demographics
NPI:1679603450
Name:ALASKA TRANSPORTATION UNLIMITED LLC
Entity Type:Organization
Organization Name:ALASKA TRANSPORTATION UNLIMITED LLC
Other - Org Name:EAGLE CAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS ADMIN MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:NORTHRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-456-8536
Mailing Address - Street 1:543 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3435
Mailing Address - Country:US
Mailing Address - Phone:907-456-7474
Mailing Address - Fax:907-452-7171
Practice Address - Street 1:543 FRONT ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3435
Practice Address - Country:US
Practice Address - Phone:907-456-7474
Practice Address - Fax:907-452-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK223584344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKTX2235Medicaid
AKHC2235Medicaid