Healthcare Provider Details

I. General information

NPI: 1639814932
Provider Name (Legal Business Name): STRATEGIC HEALTH AK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 TAHOE DR
ANCHORAGE AK
99502-1460
US

IV. Provider business mailing address

PO BOX 92031
ANCHORAGE AK
99509-2031
US

V. Phone/Fax

Practice location:
  • Phone: 907-205-0290
  • Fax:
Mailing address:
  • Phone: 907-205-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: SAVANAH EVANS
Title or Position: OWNER/FOUNDER/CEO
Credential:
Phone: 907-205-0290