Provider Demographics
NPI:1477891364
Name:ALASKA HEART INSTITUTE
Entity type:Organization
Organization Name:ALASKA HEART INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SKOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-561-3211
Mailing Address - Street 1:3841 PIPER ST
Mailing Address - Street 2:SUITE T100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4624
Mailing Address - Country:US
Mailing Address - Phone:907-561-3211
Mailing Address - Fax:
Practice Address - Street 1:3220 PROVIDENCE DR
Practice Address - Street 2:SUITE E3-083
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4679
Practice Address - Country:US
Practice Address - Phone:907-561-3211
Practice Address - Fax:907-562-7547
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALASKA HEART INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-28
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK984380261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK02-C0001016OtherMEDICARE
AKK165540OtherPTAN