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Organization

FAIRBANKS MEMORIAL HOSPITAL

Active
Parent organization
BANNER HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS E DAHLEN (VICE PRESIDENT/FINANCE)
(602) 747-4000
Entity
Organization

Contact information

Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5998
(907) 452-8181
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
282N00000X
General Acute Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1005551
AK
05
1021279 (PSYCH)
AK
05
HS03AW
AK
Enumeration date
06/08/2006
Last updated
11/25/2013
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