Alaskan Sourdough Enterprises

LBN: Alaskan Sourdough Enterprises
Alaskan Sourdough Enterprises is an health care organization with primary practice located at 225 Phillips Dr , Kenai AK 99611-8447. The organization recently has only one registered license in Agencies / Home Health, which is considered as the primary health care specialty. Alaskan Sourdough Enterprises can be contacted via phone (907) 335-0559, or through Johnson, Vincent Malone via phone (907) 335-0559.

Contact Information

Primary practice address
225 Phillips Dr Kenai AK 99611-8447
Phone: (907) 335-0559
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Vincent Malone
Phone: (907) 335-0559

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 925679 Alaska

Profile Details

NPI number 1558686634
LBN Legal business name Alaskan Sourdough Enterprises
DBA Doing business as
Authorized official Johnson, Vincent Malone
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2010
Last updated Apr 1st, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558686634 NPPES
Alaska MEDICAID 2580

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