| Heritage Family Medicine Llc | |
|
4961 E Mayflower Ln Wasilla AK 99654-7708 | |
| (907) 376-5337 | |
| Not Available |
| Full Name | Heritage Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4961 E Mayflower Ln, Wasilla, Alaska |
| Authorized Official Name and Position | Christopher Sahlstrom (OWNER) |
| Authorized Official Contact | 9079825300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Family Medicine Llc 4931 E Mayflower Ln Suite 1 Wasilla AK 99654-7759 Ph: (907) 376-5337 | Heritage Family Medicine Llc 4961 E Mayflower Ln Wasilla AK 99654-7708 Ph: (907) 376-5337 |
| NPI Number | 1699004853 |
|---|---|
| Provider Enumeration Date | 12/17/2009 |
| Last Update Date | 03/15/2021 |
| Medicare PECOS PAC ID | 5193869808 |
|---|---|
| Medicare Enrollment ID | O20100218000733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699004853 | NPI | - | NPPES |
| MD0506 | Medicaid | AK | |
| MPG0164 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 6506 (Alaska) | Primary |
| Provider Name | Christopher James Sahlstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104858604 PECOS PAC ID: 4587733316 Enrollment ID: I20081022000685 |
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