Organization
MEDICAL NETWORK OF ALASKA, LLC
Active
Parent organization
MEDICAL NETWORK OF ALASKA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL NETWORK OF ALASKA, LLC
Authorized official
JACQUELYN RENEE BLOMKER (DIRECTOR OF REVENUE CYCLE)
(907) 864-4625
Entity
Organization
Contact information
Practice address
3331 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 864-4625
(907) 313-1540
Mailing address
3331 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 864-4625
(907) 313-1540
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2103226
STATE OF ALASKA BUSINESS LICENSE
AK
Enumeration date
09/22/2022
Last updated
01/30/2024
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