Organization · NPI-2
Express Care Ak LLC
Clinic/Center · Eagle River, AK
NPI number1376003095
StatusActive
Last updated in NPPESMay 6, 2025
Details
- NPI
- 1376003095
- Entity type
- Organization (NPI-2)
- Legal business name
- Express Care Ak LLC
- Organization subpart
- No
- Enumeration date
- Mar 20, 2019
- Certification date
- May 6, 2025
- Last updated
- May 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
17101 Snowmobile Ln Ste 114Eagle River, AK 99577-7043
Phone 888-227-3312
Mailing address
Po Box 5608Portland, OR 97228-5608
Phone 888-227-3312 · Fax 425-276-3215
Authorized official
Donald Wayne Anderson
Assistant Secretary Of Enrollments
4253589786
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