EAGLE RIVER PRIMARY CARE; NPI #1235319450

Contact Information

EAGLE RIVER PRIMARY CARE

11462 BUSINESS BLVD
EAGLE RIVER, AK 99577-7721

Phone: 907-694-0770
Fax: 907-694-1378
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical	363AM0700X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for EAGLE RIVER PRIMARY CARE

NPI Number 1235319450

LBN Legal business name EAGLE RIVER PRIMARY CARE

Authorized official JENNIFER OXFORD - (REGISTERED AGENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/05/2007

Last updated 05/21/2020 - About 6 years ago

Identifiers

AK	License #	PA448
AK	Medicaid	MD42453
AK	Medicaid	MD57671
AK	Other	1326187055	INDIVIDUAL NPI
AK	Other	1407920085	INDIVIDUAL NPI
AK	Other	$$$$$$$$$	INDIVIDUAL SSN

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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EAGLE RIVER PRIMARY CARE

Contact Information

Specialty

Medical

NPI Profile & details for EAGLE RIVER PRIMARY CARE

Reviews for EAGLE RIVER PRIMARY CARE