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NPI Code Detail

MEDICARE: MARY CONRAD CENTER

MEDICARE: MARY CONRAD CENTER
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
13140N1450XPediatric Skilled Nursing FacilityAK

Other Identifiers

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

General Provider Information

NPI Number : 1538166863
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY CONRAD CENTER
Provider Business Mailing Address
First Line : 9100 CENTENNIAL CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99504-1480
Country : US
Telephone Number : 907-333-8100
Fax Number : 907-338-6789
Provider Business Practice Location Address
First Line : 9100 CENTENNIAL CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99504-1480
Country : US
Telephone Number : 907-333-8100
Fax Number : 907-338-6789
Authorized Official
Title or Position : DIRECTORY
Name : JODY HOWORTH
Credential :
Telephone Number : 907-269-3201
Provider Enumeration Date : 07/01/2005
Last Update Date : 08/22/2020

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