MEDICARE: MEDEVAC ALASKA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance		AK

General Provider Information

NPI Number	:	1285173880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDEVAC ALASKA LLC

Provider Business Mailing Address
First Line	:	PO BOX 190044
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99519-0044
Country	:	US
Telephone Number	:	907-957-1208
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 CARL BRADY DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-1801
Country	:	US
Telephone Number	:	907-310-9001
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIP FANNING
Credential	:
Telephone Number	:	907-957-1208

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	03/03/2026

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Directions to “MEDEVAC ALASKA LLC ” Practice Location

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