| Bsd- Dena A Coy | |
|
4130 San Ernesto Ave Anchorage AK 99508-2875 | |
| (907) 729-5070 | |
| Not Available |
| Full Name | Bsd- Dena A Coy |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4130 San Ernesto Ave, Anchorage, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bsd- Dena A Coy Po Box 35198 Seattle WA 98124-5198 Ph: () - | Bsd- Dena A Coy 4130 San Ernesto Ave Anchorage AK 99508-2875 Ph: (907) 729-5070 |
| NPI Number | 1184678559 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 04/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184678559 | NPI | - | NPPES |
| 1000855 | Medicaid | AK | |
| 1021095 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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