NPIMap

Organization Active NPI

Pavilion Health Company, LLC

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
National Provider Identifier
1508693474
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PAVILION HEALTH COMPANY, LLC
Practice address
2421 E Tudor Rd Ste 102
Anchorage, AK 99507-1166
Phone
(314) 402-7432
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Nagaraj V Kunda
Title
Owner/Director
Phone
(314) 312-5588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2421 E Tudor Rd Ste 102
Anchorage, AK 99507-1166

Mailing address

11520 Saint Charles Rock Rd Ste 105a
Bridgeton, MO 63044-2732
Phone (314) 475-5078

National Provider Directory

National Provider Directory
Tax ID family
Pavilion Health Company LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1508693474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 SAINT CHARLES ROCK RD STE 105A",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442732",
            "telephone_number": "314-475-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E TUDOR RD STE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071166",
            "telephone_number": "314-402-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION HEALTH COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "KUNDA",
        "authorized_official_first_name": "NAGARAJ",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "314-312-5588"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.