Organization
INDEPENDENCE IMAGING
Active
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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