MEDICARE: PATIENT HOUSING AT ANMC

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	282N00000X	General Acute Care Hospital	255468	AK

General Provider Information

NPI Number	:	1518406347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT HOUSING AT ANMC

Provider Business Mailing Address
First Line	:	4315 DIPLOMACY DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5926
Country	:	US
Telephone Number	:	907-729-2850
Fax Number	:	907-729-2362

Provider Business Practice Location Address
First Line	:	4001 TUDOR CENTRE DRIVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5932
Country	:	US
Telephone Number	:	907-729-2850
Fax Number	:	907-729-2362

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. GARVIN FEDERENKO
Credential	:
Telephone Number	:	907-729-2850

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	02/13/2017

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