BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION (NPI# 1487707790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487707790 |
| Entity Type | Organization |
| Organization Name | BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION |
| Other Organization Name | BCDC |
| Practice Address |
1905 Cowles St Fairbanks AK 99701-5914 |
| Practice Telephone | 9074793909 |
| Practice Fax Number | 9074792215 |
| Mailing Telephone | 9074793909 |
| Mailing Fax Number | 9074792215 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2013-10-08 |
| Authorized Official Name | MRS. ODETTE BUTLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9074793909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
235774 | AK | Ambulatory Health Care Facilities |
| Y | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
235774 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BLUE CROSS | 149193 | 01 |
| AK | XR5382 | 05 |
| Other Name | Type Code |
|---|---|
| BCDC | Other Name - Individual/Organization |
| Street Address |
1905 COWLES ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-5914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588085435 | Thomas Deblauw | Physician Assistant | 1905 Cowles St, Fairbanks, AK 99701-5914 | 2013-12-19 |
| 1528490802 | Breast Cancer Detection Center of Alaska (bcdc) | Voluntary or Charitable | 1905 Cowles St, Fairbanks, AK 99701-5914 | 2013-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 261QR0206X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mammography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184174831 | Community Health Imaging Centers | Clinic/Center | 259 Seldovia Street, Seldovia, AK 99663 | 2016-10-06 |
Please comment or provide details below to improve the information on BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.