Farthest North Prosthetics and Orthotics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

BL272686 Issued in AK

Legal business name

FARTHEST NORTH PROSTHETICS AND ORTHOTICS

Practice address

3520 Industrial Ave
Fairbanks, AK 99701-7376

Phone

(907) 455-9255

Fax

(907) 455-6532

NPI assigned

Jun 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raymond Gilligan

Title

Prosthetist Orthotist

Phone

(907) 455-9255

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230681600000",
    "number": "1295930600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 INDUSTRIAL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017376",
            "telephone_number": "907-455-9255",
            "fax_number": "907-455-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 INDUSTRIAL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017376",
            "telephone_number": "907-455-9255",
            "fax_number": "907-455-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARTHEST NORTH PROSTHETICS AND ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2008-12-31",
        "status": "A",
        "authorized_official_last_name": "GILLIGAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PROSTHETIST ORTHOTIST",
        "authorized_official_telephone_number": "907-455-9255"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AK",
            "license": "BL272686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fairbanks, AK
• Prosthetic/Orthotic Supplier in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.