Basic Information
| Provider Information | |||||||||
| NPI: | 1518389303 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALASKA URGENT CARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E DIMOND BLVD | ||||||||
| Address2: | #12 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995151908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073417757 | ||||||||
| FaxNumber: | 9073417760 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 E DIMOND BLVD | ||||||||
| Address2: | #12 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995151908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073417757 | ||||||||
| FaxNumber: | 9073417760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2014 | ||||||||
| LastUpdateDate: | 01/13/2014 | ||||||||
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| AuthorizedOfficialLastName: | OSWALD | ||||||||
| AuthorizedOfficialFirstName: | MAURY | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9073417757 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | 997840 | AK | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.