Organization
INDEPENDENCE IMAGING
Active
Parent organization
INDEPENDENCE HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE HEALTHCARE
Authorized official
MERCY BERG (OFFICE MANAGER)
(907) 262-6454
Entity
Organization
Contact information
Practice address
291 N FIREWEED ST, SOLDOTNA, AK 99669-7540
(907) 262-6454
Mailing address
291 N FIREWEED ST, SOLDOTNA, AK 99669-7540
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1049853
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049853
BUSINESS LICENSE
AK
Enumeration date
03/15/2017
Last updated
03/15/2017
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