Provider Demographics
NPI:1134425564
Name:QUTEKCAK NATIVE TRIBE
Entity type:Organization
Organization Name:QUTEKCAK NATIVE TRIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ELDERS PC
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:CC
Authorized Official - Phone:907-224-3118
Mailing Address - Street 1:PO BOX 1467
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-1467
Mailing Address - Country:US
Mailing Address - Phone:907-224-3118
Mailing Address - Fax:907-224-5874
Practice Address - Street 1:221 THIRD AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-1467
Practice Address - Country:US
Practice Address - Phone:907-224-3118
Practice Address - Fax:907-224-5874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management