# MOONGANG INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairbanks Urgent Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437224573
- **Authorized official:** LEONIE HORSTER DERAMUS MD (PRESIDENT)
- **Authorized official phone:** (907) 452-2178

## Contact information

- **Practice address:** 1867 AIRPORT WAY, STE 130B, FAIRBANKS, AK 99701-4056
- **Practice address phone:** (907) 452-2178
- **Practice address fax:** (907) 452-3524
- **Mailing address:** 1867 AIRPORT WAY, STE 130B, FAIRBANKS, AK 99701-4056
- **Mailing address phone:** (907) 452-2178
- **Mailing address fax:** (907) 452-3524

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 06/25/2008