Healthcare Provider Details

I. General information

NPI: 1760159933
Provider Name (Legal Business Name): ZIA MEDICAL ALASKA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 LATOUCHE ST STE 380
ANCHORAGE AK
99508-4261
US

IV. Provider business mailing address

3500 LATOUCHE ST STE 380
ANCHORAGE AK
99508-4261
US

V. Phone/Fax

Practice location:
  • Phone: 907-302-7367
  • Fax:
Mailing address:
  • Phone: 907-302-7367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
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: JENNIFER DIANE FRAISER
Title or Position: OWNER
Credential: COF
Phone: 907-302-7367