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2521 E. Mountain Village Drive Suites E And F Wasilla AK 99654 | |
| (907) 290-3760 | |
| (907) 631-0647 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2521 E. Mountain Village Drive Suites E And F, Wasilla, Alaska |
| Authorized Official Name and Position | Cindy Gaither (VP REVENUE CYCLE MGMT) |
| Authorized Official Contact | 6022488886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8444 N 90th St Ste 100 Scottsdale AZ 85258-4437 Ph: (602) 248-8886 | 2521 E. Mountain Village Drive Suites E And F Wasilla AK 99654 Ph: (907) 290-3760 |
| NPI Number | 1659722114 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 07/15/2024 |
| Certification Date | 02/10/2024 |
| Medicare PECOS PAC ID | 8729414362 |
|---|---|
| Medicare Enrollment ID | O20200130001475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659722114 | NPI | - | NPPES |
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