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Contact Information

TANANA VALLEY CLINIC LLC
570 RIVERSTONE WAY
FAIRBANKS, AK99709-2940
 Phone: 907-459-3500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
Indicates primary specialty

NPI Profile & details for TANANA VALLEY CLINIC LLC

NPI Number 1073081485
LBN Legal business name TANANA VALLEY CLINIC LLC
Authorized official STEPHEN LESLIE - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/05/2018
Last updated 11/05/2018 - About 8 years ago
Identifiers
AK Medicaid 1656221
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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