Healthcare Provider Details

I. General information

NPI: 1093712358
Provider Name (Legal Business Name): CHUGACH ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE OTIS PKWY STE 222
ANCHORAGE AK
99508-5230
US

IV. Provider business mailing address

14700 28TH AVE N STE 20
PLYMOUTH MN
55447-4876
US

V. Phone/Fax

Practice location:
  • Phone: 907-550-6111
  • Fax: 907-550-6326
Mailing address:
  • Phone: 763-559-3779
  • Fax: 763-450-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateAK

VIII. Authorized Official

Name: BRION J. BEERLE
Title or Position: MEMBER MANAGER
Credential: MD
Phone: 907-550-6111