Healthcare Provider Details

I. General information

NPI: 1366074866
Provider Name (Legal Business Name): ALASKA EHEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLD SEWARD HWY STE 203
ANCHORAGE AK
99503-6068
US

IV. Provider business mailing address

4000 OLD SEWARD HWY STE 203
ANCHORAGE AK
99503-6068
US

V. Phone/Fax

Practice location:
  • Phone: 907-770-2626
  • Fax:
Mailing address:
  • Phone: 907-770-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARYANA V BOYCE
Title or Position: BUSINESS OPERATIONS MANAGER
Credential:
Phone: 907-770-2626