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Contact Information

BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION
1905 COWLES ST
FAIRBANKS, AK99701-5914
 Phone: 907-479-3909
 Fax: 907-479-2215
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiology, Mammography

261QR0206X
 

Radiology, Mobile Mammography

261QR0207X 45 Mammography Center
Indicates primary specialty

NPI Profile & details for BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION

NPI # 1487707790
LBN Legal business name BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION
Authorized official ODETTE BUTLER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/19/2007
Last updated 10/08/2013 - About 13 years ago
Identifiers
AK License # 235774
AK Medicaid XR5382
AK Other 149193 BLUE CROSS
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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