Organization · NPI-2

Meadowcreek Healthcare

Clinic/Center · Eagle River, AK

NPI number1760717813
StatusActive
Last updated in NPPESOct 7, 2009

Details

NPI
1760717813
Entity type
Organization (NPI-2)
Legal business name
Meadowcreek Healthcare
Organization subpart
No
Enumeration date
Oct 7, 2009
Last updated
Oct 7, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center423AKYes

Practice location

16839 Park Place St
Eagle River, AK 99577-7819

Phone 907-694-3303 · Fax 907-694-4773

Mailing address

16839 Park Place St
Eagle River, AK 99577-7819

Phone 907-694-3303 · Fax 907-694-4773

Authorized official

Thomas A Fenger
Provider
9076943303

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