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General NPI Number Information
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NPI Number | 1871704395
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Entity Type | Organization
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Legal Business Name | COUNCIL OF ATHABASCAN TRIBAL GOVERNMENTS
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 101 SPRUCE STREET
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City | FORT YUKON
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State | AK
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Zip | 99740
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Country | US
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Telephone | 907-662-2460
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Fax | 907-662-2709
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Provider Business Mailing Address
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Address Line | PO BOX 309
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City | FORT YUKON
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State | AK
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Zip | 99740
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Country | US
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Telephone | 907-662-2460
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Fax | 907-662-2709
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Authorized Official
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Title or Position | EHR BILLING COORDINATOR
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Name | TAMARA KAY THOMAS
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Credential |
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Telephone | 907-662-2460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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