Provider Demographics
NPI:1780072603
Name:EPOCH - ALASKA LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:EPOCH - ALASKA LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-239-9801
Mailing Address - Street 1:3074 MT. VIEW DRIVE
Mailing Address - Street 2:SUITE 193
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501
Mailing Address - Country:US
Mailing Address - Phone:907-202-8282
Mailing Address - Fax:
Practice Address - Street 1:3074 MT. VIEW DRIVE
Practice Address - Street 2:SUITE 193
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501
Practice Address - Country:US
Practice Address - Phone:907-202-8282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty