MEDICARE: PEAK MEDICAL EQUIPMENT, 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	332B00000X	Durable Medical Equipment & Medical Supplies	10030140	AK

General Provider Information

NPI Number	:	1760866594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK MEDICAL EQUIPMENT, LLC

Provider Business Mailing Address
First Line	:	1102 E. NORTHERN LIGHTS BLVD.
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4219
Country	:	US
Telephone Number	:	907-331-3612
Fax Number	:	206-374-8248

Provider Business Practice Location Address
First Line	:	1102 E. NORTHERN LIGHTS BLVD.
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4219
Country	:	US
Telephone Number	:	907-331-3612
Fax Number	:	206-374-8248

Authorized Official
Title or Position	:	PRESIDENT/PARTNER
Name	:	GRAHAM ALEXANDER GLASS
Credential	:	M.D.
Telephone Number	:	907-312-5677

Provider Enumeration Date	:	07/10/2015
Last Update Date	:	07/18/2018

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