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General NPI Number Information
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NPI Number | 1720039076
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Entity Type | Organization
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Legal Business Name | FAIRBANKS NORTH STAR BOROUGH
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 3175 PEGER RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-5454
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Country | US
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Telephone | 907-459-1481
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71122
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City | FAIRBANKS
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State | AK
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Zip | 99707-1122
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Country | US
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Telephone | 907-459-8200
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Fax | 907-459-8201
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Authorized Official
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Title or Position | EMERGENCY SERVICES ADMINISTRATOR
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Name | BRAD PAULSON
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Credential |
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Telephone | 907-459-1481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0230
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License Number State | AK
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