1740351329 NPI number — CITY OF KOTZEBUE

Table of content: (NPI 1740351329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740351329 NPI number — CITY OF KOTZEBUE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF KOTZEBUE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KOTZEBUE FIRE DEPARTMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740351329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3510
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-238-9398
Provider Business Mailing Address Fax Number:
360-394-7097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3RD AND BISON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KOTZEBUE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-442-3401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ATKINSON
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
CITY MANAGER
Authorized Official Telephone Number:
907-442-3401

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  6015 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GA4434 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".