Provider Demographics
NPI:1851863765
Name:ALASKA MEDICAL ALLIANCE LLC
Entity Type:Organization
Organization Name:ALASKA MEDICAL ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CUDMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-339-2455
Mailing Address - Street 1:3831 PIPER ST STE S220
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4680
Mailing Address - Country:US
Mailing Address - Phone:907-563-3145
Mailing Address - Fax:
Practice Address - Street 1:3831 PIPER ST STE S220
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4680
Practice Address - Country:US
Practice Address - Phone:907-563-3145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty