MEDICARE: ALASKA FAMILY SONOGRAMS, INC

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	261QR0200X	Radiology Clinic/Center		AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518033281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALASKA FAMILY SONOGRAMS, INC

Provider Business Mailing Address
First Line	:	3600 LAKE OTIS PKWY STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5225
Country	:	US
Telephone Number	:	907-561-3601
Fax Number	:	907-561-3900

Provider Business Practice Location Address
First Line	:	3600 LAKE OTIS PKWY STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5225
Country	:	US
Telephone Number	:	907-561-3601
Fax Number	:	907-561-3900

Authorized Official
Title or Position	:	SECRETARY-TREASURER
Name	:	MRS. RADINE WILLIAMS-BOSS
Credential	:
Telephone Number	:	907-561-3601

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	07/21/2022

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