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Organization
MAT-SU VALLEY III LLC
Active
Organization
MAT-SU VALLEY III LLC
Active
Other names
Mat Su Urgent Care - Palmer
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SENIOR DIRECTOR)
(615) 465-3334
Entity
Organization
Contact information
Practice address
209 W EVERGREEN AVE, PALMER, AK 99645-6952
(907) 861-1400
(907) 861-1405
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7042
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AK
Enumeration date
12/07/2017
Last updated
06/15/2021
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