Healthcare Provider Details

I. General information

NPI: 1740218932
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF ALASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 LAKE OTIS PKWY
ANCHORAGE AK
99508-5211
US

IV. Provider business mailing address

4001 LAKE OTIS PKWY
ANCHORAGE AK
99508-5211
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-2229
  • Fax: 907-565-7529
Mailing address:
  • Phone: 907-563-2229
  • Fax: 907-565-7529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CLOVER SIMON
Title or Position: CEO
Credential: MSW
Phone: 907-770-9705