# INDEPENDENCE HEALTHCARE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Independence Healthcare Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124667498
- **Authorized official:** HENRY G KRULL (MD/OWNER)
- **Authorized official phone:** (907) 262-6454

## Contact information

- **Practice address:** 100 TRADING BAY RD STE 8, KENAI, AK 99611-7786
- **Practice address phone:** (907) 283-4633
- **Practice address fax:** (907) 262-0832
- **Mailing address:** 291 N FIREWEED ST, SOLDOTNA, AK 99669-7540
- **Mailing address phone:** (907) 262-6454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2020
- **Last updated:** 02/25/2020