Healthcare Provider Details

I. General information

NPI: 1134344831
Provider Name (Legal Business Name): CAPITAL CAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 GLACIER HWY
JUNEAU AK
99801
US

IV. Provider business mailing address

PO BOX 240854
DOUGLAS AK
99824-0854
US

V. Phone/Fax

Practice location:
  • Phone: 907-586-2772
  • Fax: 907-789-1914
Mailing address:
  • Phone: 907-586-2772
  • Fax: 907-789-1914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL D. LAFLIN
Title or Position: OFFICE MANAGER
Credential: 03-28-61
Phone: 907-586-2772