Healthcare Provider Details

I. General information

NPI: 1902051204
Provider Name (Legal Business Name): JOHNSON'S LTD,. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9057 N. LINDA LN.
WILLOW AK
99088
US

IV. Provider business mailing address

PO BOX 674
WILLOW AK
99688-0674
US

V. Phone/Fax

Practice location:
  • Phone: 907-495-6200
  • Fax: 907-495-6200
Mailing address:
  • Phone: 907-495-6200
  • Fax: 907-495-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KARROL ANN JOHNSON
Title or Position: PRESIDENT/TREASURER
Credential:
Phone: 907-495-6200