FAIRBANKS NORTH STAR BOROUGH NPI 1720039076

NPI Information

NPI: 1720039076
Provider Name: FAIRBANKS NORTH STAR BOROUGH
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 02D0895547

Address:
3175 PEGER RD
FAIRBANKS, AK
ZIP 99709
Phone: (907) 459-1481
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FAIRBANKS NORTH STAR BOROUGH is a land transport ambulance in Fairbanks, AK. FAIRBANKS NORTH STAR BOROUGH NPI is 1720039076. The provider is registered as an organization entity type.

The provider's business location address is:

3175 PEGER RD
FAIRBANKS, AK
ZIP 99709-454
Phone: (907) 459-1481

The provider's authorized official is Brad Paulson .
The authorized official title is Emergency Services Administrator and has the following contact phone number (907) 459-1481.

The CLIA number assigned to this NPI record is 02D0895547 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 8/3/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	0230	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	337474300	OTHER	ALASKA	OWCP
2	K0000RGCBZ	MEDICARE PIN	ALASKA
3	590007983	OTHER	ALASKA	MEDICARE RR
4	TR0508	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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