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General NPI Number Information
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NPI Number | 1043358062
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF ALASKA FAIRBANKS CENTER FOR HEALTH & COUNSELING
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 612 N. CHANDALAR DR.
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City | FAIRBANKS
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State | AK
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Zip | 99775-5580
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Country | US
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Telephone | 907-474-7043
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Fax | 907-474-5777
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Provider Business Mailing Address
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Address Line | PO BOX 755580
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City | FAIRBANKS
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State | AK
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Zip | 99775-5580
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Country | US
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Telephone | 907-474-7043
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Fax | 907-474-5777
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JOHN FELLERATH
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Credential |
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Telephone | 907-474-7043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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