Healthcare Provider Details

I. General information

NPI: 1679376909
Provider Name (Legal Business Name): TANANA TRANSPORTATION LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 ASPEN ST
FAIRBANKS AK
99709-5501
US

IV. Provider business mailing address

PO BOX 80001
FAIRBANKS AK
99708-0001
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ERIC OLSON
Title or Position: MANAGER
Credential:
Phone: 907-388-2141