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General NPI Number Information
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NPI Number | 1861482903
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Entity Type | Organization
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Legal Business Name | MATANUSKA SUSITNA BOROUGH
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 350 E DAHLIA AVE
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City | PALMER
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State | AK
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Zip | 99645-6411
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Country | US
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Telephone | 907-745-9564
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Fax | 907-745-9566
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Provider Business Mailing Address
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Address Line | 350 E DAHLIA AVE
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City | PALMER
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State | AK
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Zip | 99645-6411
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOROUGH MAYER
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Name | EDNA B DEVRIES
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Credential |
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Telephone | 907-861-8564
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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 | 0425
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License Number State | AK
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