Provider Demographics
NPI:1306579164
Name:ALYESKA IMAGING CENTER, INC.
Entity type:Organization
Organization Name:ALYESKA IMAGING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-792-7975
Mailing Address - Street 1:PO BOX 75568
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-5568
Mailing Address - Country:US
Mailing Address - Phone:907-746-2929
Mailing Address - Fax:907-746-6543
Practice Address - Street 1:2480 S WOODWORTH LOOP STE 140
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7408
Practice Address - Country:US
Practice Address - Phone:907-746-2929
Practice Address - Fax:907-746-6543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty