Organization
MEDICAL NETWORK OF ALASKA, LLC
Active
Parent organization
CAPSTONE FAMILY MEDICINE, LLC
Other names
Capstone Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAPSTONE FAMILY MEDICINE, LLC
Authorized official
MRS. JACQUELYN RENEE BLOMKER (RCM)
(907) 864-4625
Entity
Organization
Contact information
Practice address
3066 E MERIDIAN PARK LOOP, SUITE 2, WASILLA, AK 99654
(907) 357-9560
(907) 357-9593
Mailing address
3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
(907) 357-9590
(907) 357-9593
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
976106
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1654525
—
AK
Enumeration date
07/23/2012
Last updated
11/02/2020
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