Revive Alaska Community Services

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

REVIVE ALASKA COMMUNITY SERVICES

Practice address

4317 Macinnes St
Anchorage, AK 99508-5135

Phone

(907) 717-9080

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Prince Nwankudu

Title

President

Phone

(907) 903-0993

Specialties & licenses 2

Addresses

Other names 1

• RACS Other name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1306560644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231568",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995231568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 MACINNES ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085135",
            "telephone_number": "907-717-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE ALASKA COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "NWANKUDU",
        "authorized_official_first_name": "PRINCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-903-0993"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tbd",
            "affiliation": "N",
            "address_1": "4317 MacInnes St",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995085135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "RACS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "RACS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Domna Reutov
• Emilya Reutov
• Flegont Reutov
• Cynthia L Revels
• Kimberly F Revels, AGACNP-BC
• Melanie Suzanne Revoltar
• Rex C. Malcom Pharmd DMD, LLC (Alaska Advanced Dentistry)
• John Rexroth Jr., MPA
• Hans Reyers
• Anna Marie Reyes

• Non-emergency Medical Transport (VAN) in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Non-emergency Medical Transport (VAN) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.