Organization
FAIRBANKS NORTHSTAR BOROUGH VAN TRAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN MILLER (TRANSPORTATION DIRECTOR)
(907) 459-1007
Entity
Organization
Contact information
Practice address
501 CUSHMAN ST, FAIRBANKS, AK 99701-4633
(907) 459-1010
(907) 459-7908
Mailing address
3175 PEGER RD, ATTN: VAN TRAN, FAIRBANKS, AK 99709-5454
(907) 459-1010
(907) 459-7908
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC3175
—
AK
Enumeration date
08/12/2008
Last updated
08/12/2008
Update your record
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