MEDICARE: BAC CAPITAL MGT

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1295002798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAC CAPITAL MGT

Provider Business Mailing Address
First Line	:	12725 LANDMARK ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-3818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9138 ARLON ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-3876
Country	:	US
Telephone Number	:	907-444-8350
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BINYON WRIGHT
Credential	:
Telephone Number	:	907-444-8350

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	11/28/2011

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