Organization
PETERSBURG BOROUGH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY TOW (FINANCE DIRECTOR)
(907) 772-4425
Entity
Organization
Contact information
Practice address
1200 HAUGEN DRIVE, PETERSBURG, AK 99833
(907) 772-3355
Mailing address
PO BOX 329, PETERSBURG, AK 99833-0329
(907) 772-4425
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5005
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GA5005
—
AK
Enumeration date
01/05/2007
Last updated
04/16/2013
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