Healthcare Provider Details

I. General information

NPI: 1538923586
Provider Name (Legal Business Name): FAIRBANKS TAXI SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 ASPEN ST
FAIRBANKS AK
99709-5501
US

IV. Provider business mailing address

PO BOX 80927
FAIRBANKS AK
99708-0927
US

V. Phone/Fax

Practice location:
  • Phone: 907-388-2141
  • Fax: 907-479-5464
Mailing address:
  • Phone: 907-388-2141
  • Fax: 907-479-5464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: ERIC IVAN OLOSN
Title or Position: MANAGER
Credential:
Phone: 907-388-2141