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Organization
TANANA VALLEY CLINIC LLC
Active
Organization
TANANA VALLEY CLINIC LLC
Active
Parent organization
FOUNDATION HEALTH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUNDATION HEALTH LLC
Authorized official
STEPHEN PAUL LESLIE (CFO)
(907) 458-3310
Entity
Organization
Contact information
Practice address
1919 LATHROP ST, FAIRBANKS, AK 99701-5937
(907) 459-3500
(907) 459-3526
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(190) 745-9350
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/03/2018
Last updated
11/03/2018
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