Provider Demographics
NPI:1710262175
Name:ANCHORAGE SCHOOL BASED HEALTH CENTERS
Entity Type:Organization
Organization Name:ANCHORAGE SCHOOL BASED HEALTH CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-802-1500
Mailing Address - Street 1:2121 ABBOTT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-4450
Mailing Address - Country:US
Mailing Address - Phone:907-802-1500
Mailing Address - Fax:
Practice Address - Street 1:150 BRAGAW ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1307
Practice Address - Country:US
Practice Address - Phone:907-522-7090
Practice Address - Fax:907-522-7095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIAN HEALTH ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-18
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1021422Medicaid