National Provider Identifier Database

FAIRBANKS MEMORIAL CARDIOLOGY CLINIC LLC
Multi-Specialty


Contact Information

FAIRBANKS MEMORIAL CARDIOLOGY CLINIC, LLC
1650 COWLES ST DEPT 61A
FAIRBANKS, AK99701-5907
Phone: 907-458-6453
Fax:
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for FAIRBANKS MEMORIAL CARDIOLOGY CLINIC, LLC

NPI Number 1942751631
Legal business name
LBN
FAIRBANKS MEMORIAL CARDIOLOGY CLINIC, LLC
Authorized official SHELLEY EBENAL - (GENERAL COUNSEL)
Entity Organization
Organization subpart Yes
Enumeration date 10/18/2016
Last updated 10/18/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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