Organization
FAIRBANKS MEMORIAL HOSPITAL
Active
Parent organization
BANNER HEALTH
Other names
Fairbanks Memorial Hospital Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS E DAHLEN (SR VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1701 GILLAM WAY, FAIRBANKS, AK 99701-6056
(907) 458-5410
(907) 458-5412
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005174
—
AK
Enumeration date
06/03/2006
Last updated
04/28/2015
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