Provider Demographics
NPI:1447917299
Name:GOLDEN VALLEY ELECTRIC ASSOCIATION
Entity type:Organization
Organization Name:GOLDEN VALLEY ELECTRIC ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SAFETY ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-451-5679
Mailing Address - Street 1:718 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:907-451-5679
Mailing Address - Fax:
Practice Address - Street 1:718 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-451-5679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization