Tanana Valley Clinic Llc

LBN: Tanana Valley Clinic Llc
Tanana Valley Clinic Llc is an health care organization with primary practice located at 1405 Kellum St , Fairbanks AK 99701-4189. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Tanana Valley Clinic Llc can be contacted via phone (907) 459-3500, or through Leslie, Stephen Paul via phone (907) 458-3310.

Contact Information

Primary practice address
1405 Kellum St Fairbanks AK 99701-4189
Phone: (907) 459-3500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Leslie, Stephen Paul
Phone: (907) 458-3310

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1073081287
LBN Legal business name Tanana Valley Clinic Llc
DBA Doing business as
Authorized official Leslie, Stephen Paul
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 6th, 2018
Last updated Nov 6th, 2018 - about 7 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 1073081287 NPPES
Alaska MEDICAID 1656193

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