Provider Demographics
NPI:1861122756
Name:WEKA MEDICAL
Entity type:Organization
Organization Name:WEKA MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-441-8559
Mailing Address - Street 1:P.O. BOX 240474
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-0474
Mailing Address - Country:US
Mailing Address - Phone:907-441-8559
Mailing Address - Fax:888-731-9515
Practice Address - Street 1:5630 B STREET
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518
Practice Address - Country:US
Practice Address - Phone:907-441-8559
Practice Address - Fax:888-731-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No3416A0800XTransportation ServicesAmbulanceAir Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)