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Contact Information

MEDICAL GROUP OF ALASKA
3190 E MERDIAN PARK LOOP
SUITE 207
WASILLA, AK99654
 Phone: 907-373-9460
 Fax: 907-373-9461
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for MEDICAL GROUP OF ALASKA

NPI # 1174882971
LBN Legal business name MEDICAL GROUP OF ALASKA
Authorized official CHRISTINE HENRY-MUSA - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/14/2012
Last updated 05/24/2022 - About 4 years ago
Identifiers
AK License # 1070929
AK License # 949810
AK Medicaid 1658871
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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