Provider Demographics
NPI:1972832145
Name:PIONEER EXTENDED CARE CENTER
Entity Type:Organization
Organization Name:PIONEER EXTENDED CARE CENTER
Other - Org Name:FAMILY INK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MURCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-250-6758
Mailing Address - Street 1:4211 COPE ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5727
Mailing Address - Country:US
Mailing Address - Phone:907-250-6758
Mailing Address - Fax:
Practice Address - Street 1:4211 COPE ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5727
Practice Address - Country:US
Practice Address - Phone:907-250-6758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service