Odland Family Practice Clinic, Llc
LBN: Odland Family Practice Clinic, Llc
Odland Family Practice Clinic, Llc is an health care organization with primary practice located at 950 E Bogard Rd Suite 234, Wasilla AK 99654-7184. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Odland Family Practice Clinic, Llc can be contacted via phone (907) 355-0850, or through Pendergrass, Shannon via phone (907) 355-0850.
Contact Information
Primary practice address
950 E Bogard Rd Suite 234
Wasilla AK 99654-7184
Phone: (907) 355-0850
Fax: (907) 373-0117
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 955730 | Alaska |
Profile Details
NPI number | 1114269313 |
---|---|
LBN Legal business name | Odland Family Practice Clinic, Llc |
DBA Doing business as | |
Authorized official | Pendergrass, Shannon CMRS |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Mar 26th, 2013 |
Last updated | Mar 26th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114269313 | NPPES |
Alaska | MEDICAID | MD1574 | |
Alaska | MEDICAID | MD9857 |
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