Provider Demographics
NPI:1194854604
Name:ALASKA EYE CARE CENTERS, APC
Entity type:Organization
Organization Name:ALASKA EYE CARE CENTERS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-272-2557
Mailing Address - Street 1:1700 E PARKS HWY # 300
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7352
Mailing Address - Country:US
Mailing Address - Phone:907-376-5266
Mailing Address - Fax:907-373-1887
Practice Address - Street 1:1700 E PARKS HWY # 300
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7352
Practice Address - Country:US
Practice Address - Phone:907-376-5266
Practice Address - Fax:907-373-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK162810OtherMEDICARE PTAN
AKOD02071Medicaid
AKOD1173Medicaid
AK161247OtherMEDICARE PTAN
AKOP0096Medicaid
AKOD0011Medicaid
AKOP0200Medicaid
AKOD5329Medicaid
AKVG0200Medicaid
AKOD1158Medicaid
AKOD1187Medicaid
AKOP0096Medicaid
AKVG0200Medicaid
AKU64684Medicare UPIN
AKU06513Medicare UPIN
AKK162810OtherMEDICARE PTAN
AKU76691Medicare UPIN
AKU47008Medicare UPIN