Healthcare Provider Details

I. General information

NPI: 1184027526
Provider Name (Legal Business Name): ALASKA MEDICAL RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2683 JEPPESEN ACRES RD
EUGENE OR
97401-4914
US

IV. Provider business mailing address

2683 JEPPESEN ACRES RD
EUGENE OR
97401-4914
US

V. Phone/Fax

Practice location:
  • Phone: 541-912-0011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1010736
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIAN BAUMGARTNER
Title or Position: PRESIDENT
Credential:
Phone: 541-912-0011