Provider Demographics
NPI:1760866594
Name:PEAK MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:PEAK MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-312-5677
Mailing Address - Street 1:1102 E. NORTHERN LIGHTS BLVD.
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4219
Mailing Address - Country:US
Mailing Address - Phone:907-331-3612
Mailing Address - Fax:206-374-8248
Practice Address - Street 1:1102 E. NORTHERN LIGHTS BLVD.
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4219
Practice Address - Country:US
Practice Address - Phone:907-331-3612
Practice Address - Fax:206-374-8248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10030140332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies