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Organization
FAIRBANKS MEMORIAL CARDIOLOGY CLINIC, LLC
Active
Organization
FAIRBANKS MEMORIAL CARDIOLOGY CLINIC, LLC
Active
Parent organization
FOUNDATION HEALTH, LLC
Other names
Fairbanks Memorial Physician Specialties
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUNDATION HEALTH, LLC
Authorized official
SHELLEY D EBENAL (GENERAL COUNSEL)
(907) 458-5550
Entity
Organization
Contact information
Practice address
1650 COWLES ST DEPT 61A, FAIRBANKS, AK 99701-5907
(907) 458-6453
Mailing address
1650 COWLES ST DEPT 61A, FAIRBANKS, AK 99701-5907
(907) 458-6453
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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