Provider Demographics
NPI:1588327209
Name:ALASKA SURGICAL FIRST ASSIST LLC
Entity type:Organization
Organization Name:ALASKA SURGICAL FIRST ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:907-385-7625
Mailing Address - Street 1:2073 MAVENCAMP CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6574
Mailing Address - Country:US
Mailing Address - Phone:907-385-7625
Mailing Address - Fax:
Practice Address - Street 1:2073 MAVENCAMP CIR
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6574
Practice Address - Country:US
Practice Address - Phone:907-385-7625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty