| Trailhead Medical Care Llc | |
|
729 Northway Dr Anchorage AK 99508-2030 | |
| (907) 644-3239 | |
| (907) 644-3983 |
| Full Name | Trailhead Medical Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 729 Northway Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Tiffany Jeanette Tate (OWNER/MEMBER) |
| Authorized Official Contact | 3039901432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trailhead Medical Care Llc 729 Northway Dr Anchorage AK 99508-2030 Ph: (907) 644-3239 | Trailhead Medical Care Llc 729 Northway Dr Anchorage AK 99508-2030 Ph: (907) 644-3239 |
| NPI Number | 1275307449 |
|---|---|
| Provider Enumeration Date | 11/08/2023 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 1850736943 |
|---|---|
| Medicare Enrollment ID | O20240228003156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275307449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tiffany Jeanette Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285224220 PECOS PAC ID: 0244635233 Enrollment ID: I20210830002212 |
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