Provider Demographics
NPI:1902078603
Name:POLAR FOODS LLC
Entity Type:Organization
Organization Name:POLAR FOODS LLC
Other - Org Name:POLAR PIEROGIES
Other - Org Type:Other Name
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KOHUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-248-2544
Mailing Address - Street 1:2605 EAGLE STREET
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-248-2544
Mailing Address - Fax:
Practice Address - Street 1:2605 EAGLE STREET
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-248-2544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK744093332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals