Organization
INTERIOR MEDICAL SUPPLY LLC
Active
Other names
Interior Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LYNN INGRAHAM (OWNER)
(907) 457-8486
Entity
Organization
Contact information
Practice address
907 E DOWLING RD, STE 25, ANCHORAGE, AK 99518-1426
(907) 561-8486
(907) 561-8488
Mailing address
915 30TH AVE STE 106, FAIRBANKS, AK 99701-7577
(907) 457-8486
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
297766
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297766
STATE BUSINESS LICENSE
AK
Enumeration date
02/18/2016
Last updated
10/07/2016
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