Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 LAKE OTIS PKWY
ANCHORAGE AK
99508-5213
US

IV. Provider business mailing address

4115 LAKE OTIS PKWY
ANCHORAGE AK
99508-5213
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-7228
  • Fax: 907-563-6278
Mailing address:
  • Phone: 907-563-7228
  • Fax: 907-563-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: B ELLEN COWGILL
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 907-563-7228