Healthcare Provider Details

I. General information

NPI: 1306579164
Provider Name (Legal Business Name): ALYESKA IMAGING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 S WOODWORTH LOOP STE 140
PALMER AK
99645-7408
US

IV. Provider business mailing address

PO BOX 75568
CHICAGO IL
60675-5568
US

V. Phone/Fax

Practice location:
  • Phone: 907-746-2929
  • Fax: 907-746-6543
Mailing address:
  • Phone: 907-746-2929
  • Fax: 907-746-6543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROSEANN B. PICKETT
Title or Position: CEO
Credential:
Phone: 907-792-7975