MEDICARE: ALASKA WOMEN'S HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician
2	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1336136936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALASKA WOMEN'S HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	4115 LAKE OTIS PKWY
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5213
Country	:	US
Telephone Number	:	907-563-7228
Fax Number	:	907-563-6278

Provider Business Practice Location Address
First Line	:	4115 LAKE OTIS PKWY
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5213
Country	:	US
Telephone Number	:	907-563-7228
Fax Number	:	907-563-6278

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	B ELLEN COWGILL
Credential	:
Telephone Number	:	907-563-7228

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	07/21/2022

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