Basic Information
| Provider Information | |||||||||
| NPI: | 1538562012 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ASSURANCE CARE COORDINATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 MISTY FJORDS CIR | ||||||||
| Address2: | UNIT B | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995082580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073017020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 MISTY FJORDS CIR | ||||||||
| Address2: | UNIT B | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995082580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073017020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2014 | ||||||||
| LastUpdateDate: | 09/29/2014 | ||||||||
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| AuthorizedOfficialLastName: | TURNBULL | ||||||||
| AuthorizedOfficialFirstName: | MIRANDA | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9073017020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | 1009140 | AK | Y | Agencies | Case Management |
No ID Information.