Provider Demographics
NPI:1649778697
Name:ALASKA ADVANCED DME LLC
Entity type:Organization
Organization Name:ALASKA ADVANCED DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-223-8414
Mailing Address - Street 1:8371 SUMMERSET DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2927
Mailing Address - Country:US
Mailing Address - Phone:907-223-8414
Mailing Address - Fax:907-771-9726
Practice Address - Street 1:8371 SUMMERSET DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2927
Practice Address - Country:US
Practice Address - Phone:907-223-8414
Practice Address - Fax:907-771-9726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies