Provider Demographics
NPI:1407907561
Name:FRONTIER MEDICAL
Entity type:Organization
Organization Name:FRONTIER MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LINDGREN
Authorized Official - Last Name:CHACON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-644-9407
Mailing Address - Street 1:907 E DOWLING RD STE 26
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1427
Mailing Address - Country:US
Mailing Address - Phone:907-258-8618
Mailing Address - Fax:907-644-9458
Practice Address - Street 1:907 E DOWLING RD STE 26
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1427
Practice Address - Country:US
Practice Address - Phone:907-258-8618
Practice Address - Fax:907-644-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK708007332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment