Basic Information
| Provider Information | |||||||||
| NPI: | 1205111903 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTONIO | ||||||||
| FirstName: | WILMER | ||||||||
| MiddleName: | RALPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6637 WINCHESTER ST | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9079292828 | ||||||||
| FaxNumber: | 9079295858 | ||||||||
| Practice Location | |||||||||
| Address1: | 6637 WINCHESTER ST | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9079292828 | ||||||||
| FaxNumber: | 9079295858 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2011 | ||||||||
| LastUpdateDate: | 10/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 372500000X | N | Nursing Service Related Providers | Chore Provider | 3747P1801X | Y | Nursing Service Related Providers | Technician | Personal Care Attendant |
No ID Information.