# MAT SU VALLEY MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAT SU VALLEY MEDICAL CENTER LLC
- **Other names:** Mat-Su Regional Urgent Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912950148
- **Legal business name:** MAT SU VALLEY MEDICAL CENTER LLC
- **Authorized official:** KRISTINA MUSIC (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 892-9815

## Contact information

- **Practice address:** 950 E BOGARD RD STE 103, WASILLA, AK 99654-7184
- **Practice address phone:** (907) 352-2880
- **Practice address fax:** (907) 352-2885
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7042
- **Mailing address fax:** (615) 628-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261Q00000X | Clinic/Center | 299454 | AK | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 04/21/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1020601 | — | AK |