Provider Demographics
NPI:1265577126
Name:ANIAK VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:ANIAK VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-675-4481
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:ANIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99557-0307
Mailing Address - Country:US
Mailing Address - Phone:907-675-4481
Mailing Address - Fax:907-675-4486
Practice Address - Street 1:307 AIRPORT RD.
Practice Address - Street 2:
Practice Address - City:ANIAK
Practice Address - State:AK
Practice Address - Zip Code:99557-0307
Practice Address - Country:US
Practice Address - Phone:907-675-4481
Practice Address - Fax:907-675-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6220341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKGA6220Medicaid
AK6220OtherAMBULANCE CERTIFICATION
AKGA6220Medicaid