Provider Demographics
NPI:1730113739
Name:PATIENTS FIRST MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:PATIENTS FIRST MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-375-5200
Mailing Address - Street 1:6307 DEBARR RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1701
Mailing Address - Country:US
Mailing Address - Phone:907-333-7425
Mailing Address - Fax:907-333-7719
Practice Address - Street 1:6307 DEBARR RD
Practice Address - Street 2:SUITE C
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1701
Practice Address - Country:US
Practice Address - Phone:907-333-7425
Practice Address - Fax:907-333-7719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK666363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMDA0056Medicaid
AKNP6817Medicaid
AKNP39831Medicaid
AKNP5159Medicaid
AKNP99111Medicaid
AKMD14492Medicaid
AKK160748Medicare PIN
AKQ10316Medicare UPIN
AKNP39831Medicaid
AKP97920Medicare UPIN
AKK153074Medicare PIN
AKQ80800Medicare UPIN
AKMDA0056Medicaid
AKNP6817Medicaid
AKNP5159Medicaid