MEDICARE: LIFEMED ALASKA, 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	3416A0800X	Air Ambulance	915056	AK
2	3416A0800X	Air Ambulance	9300	AK
3	3416A0800X	Air Ambulance	4300	AK
4	3416L0300X	Land Ambulance	3300	AK
5	341600000X	Ambulance	4300	AK
6	3416L0300X	Land Ambulance	3305	AK
7	3416L0300X	Land Ambulance	3200	AK
8	3416L0300X	Land Ambulance	3220	AK
9	3416A0800X	Air Ambulance	6300	AK
10	341600000X	Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	K165057	OTHER	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	K161982	OTHER	PTAN

General Provider Information

NPI Number	:	1871754473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFEMED ALASKA, LLC

Provider Business Mailing Address
First Line	:	6320 S AIRPARK PL
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-1818
Country	:	US
Telephone Number	:	907-563-6633
Fax Number	:	907-563-6636

Provider Business Practice Location Address
First Line	:	3838 W 50TH AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-0903
Country	:	US
Telephone Number	:	907-563-6633
Fax Number	:	907-563-6636

Authorized Official
Title or Position	:	CEO
Name	:	MRS. GRACE GREENE
Credential	:
Telephone Number	:	907-249-8451

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	02/18/2026

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Directions to “LIFEMED ALASKA, LLC ” Practice Location

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