# URGENT CARE AT LAKE LUCILLE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275587768
- **Authorized official:** MRS. ELLEN R VAROSI (FINANCIAL OFFICER)
- **Authorized official phone:** (907) 373-4200

## Contact information

- **Practice address:** 185 E PARKS HWY, WASILLA, AK 99654-7038
- **Practice address phone:** (907) 373-4203
- **Practice address fax:** (907) 373-4201
- **Mailing address:** 185 E PARKS HWY, WASILLA, AK 99654-7038
- **Mailing address phone:** (907) 373-4203
- **Mailing address fax:** (907) 373-4201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3064 | AK | — |
| 261QU0200X | Urgent Care Clinic/Center | 157496 | AK | — |
| 261QU0200X | Urgent Care Clinic/Center | 3064 | AK | Yes |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 04/21/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | MDG043 | — | AK |
| 05 | — | MDG496 | — | AK |