Basic Information
| Provider Information | |||||||||
| NPI: | 1528334539 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALASKA SLEEP DISORDER CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 PIPER ST | ||||||||
| Address2: | SUITE T345 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995084624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075656000 | ||||||||
| FaxNumber: | 9075656000 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 LATOUCHE ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995084208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075656000 | ||||||||
| FaxNumber: | 9075656000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2012 | ||||||||
| LastUpdateDate: | 03/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | LEHRMANN | ||||||||
| AuthorizedOfficialFirstName: | ELI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9075656000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 970663 | AK | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084S0012X | 970663 | AK | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |
No ID Information.