Provider Demographics
NPI:1689071409
Name:ALASKA SLEEP CLINIC INC
Entity Type:Organization
Organization Name:ALASKA SLEEP CLINIC INC
Other - Org Name:SOMNOSURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-420-0540
Mailing Address - Street 1:3920 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5210
Mailing Address - Country:US
Mailing Address - Phone:907-770-9104
Mailing Address - Fax:907-770-8965
Practice Address - Street 1:9914 KENNERLY RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2787
Practice Address - Country:US
Practice Address - Phone:907-420-0540
Practice Address - Fax:907-420-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK293910261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic