1750485488 NPI number — CITY OF VALDEZ

Table of content: (NPI 1750485488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750485488 NPI number — CITY OF VALDEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF VALDEZ
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:
Provider Other Organization Name Type Code:
6
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:
1750485488
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALDEZ
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99686-0550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-835-2249
Provider Business Mailing Address Fax Number:
907-834-1890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
911 MEALS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALDEZ
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99686-0550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-835-2249
Provider Business Practice Location Address Fax Number:
907-834-1890
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
ASSISTANT SECRETARY OF ENROLLMENTS
Authorized Official Telephone Number:
425-358-9786

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X , 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: HS027OP , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: HS027IP , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".




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