Provider Demographics
NPI:1609584036
Name:ALYESKA INTERNATIONAL INC.
Entity type:Organization
Organization Name:ALYESKA INTERNATIONAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-420-0540
Mailing Address - Street 1:588 PACE ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7668
Mailing Address - Country:US
Mailing Address - Phone:907-420-0540
Mailing Address - Fax:907-420-0541
Practice Address - Street 1:545 N KNIK ST STE A
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7022
Practice Address - Country:US
Practice Address - Phone:907-357-6700
Practice Address - Fax:907-357-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1638639Medicaid