| Name: | ALASKA INTERNAL MEDICINE AND PEDIATRICS, LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 14 Jun 2002 (23 years ago) |
| Entity Number: | 76783D |
| ZIP code: | 99516 |
| County: | Anchorage |
| Place of Formation: | ALASKA |
| Address: | 6195 GREECE DR, ANCHORAGE, AK 99516 |
| Mailing Address: | 4048 LAUREL ST STE 306, ANCHORAGE, AK 99508 |
| Supporting healthcare providers fighting with COVID-19: | $43,981 |
Line of Business
62 Health Care and Social AssistanceNAICS
621498 ALL OTHER OUTPATIENT CARE CENTERS| Name | Role |
|---|---|
| Michele O'Fallon | Member |
| Laurie Montano | Member |
| MICHELE O'FALLON | Registered Agent |
| Unique Entity ID | Expiration Date | Physical Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CXKAU9XBGEV7 | 2024-06-19 | 4048 LAUREL ST, STE 306, ANCHORAGE, AK, 99508, 5391, USA | |||||||||||||||||||||||||||||||||||||||||||
|
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| Division Name | ALASKA INTERNAL MEDICINE & PEDIATRICS |
| Congressional District | 00 |
| State/Country of Incorporation | AK, USA |
| Activation Date | 2023-06-22 |
| Initial Registration Date | 2022-01-19 |
| Entity Start Date | 2002-09-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621111 |
| Product and Service Codes | Q509 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | CERENA A WARNER |
| Address | 13111 GROUSE HOLLOW DR NW, GIG HARBOR, WA, 98329, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | PAULA DONNELLY |
| Address | 4048 LAUREL ST STE 306, ANCHORAGE, AK, 99508, USA |
| Past Performance | - |
|---|
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 290395 | Business License | Active | 2002-06-28 | 2023-10-19 | 2025-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| 159162 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2020-03-19 | 2020-03-19 | - |
| 217514 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2023-11-28 | 2023-11-28 | - |
Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
