Odland Family Practice Clinic, Llc

LBN: Odland Family Practice Clinic, Llc
Odland Family Practice Clinic, Llc is an health care organization with primary practice located at 950 E Bogard Rd Suite 234, Wasilla AK 99654-7184. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Odland Family Practice Clinic, Llc can be contacted via phone (907) 355-0850, or through Pendergrass, Shannon via phone (907) 355-0850.

Contact Information

Primary practice address
950 E Bogard Rd Suite 234 Wasilla AK 99654-7184
Phone: (907) 355-0850
Fax: (907) 373-0117
Website:
Map and Directions
Authorized official contact:
Name: Pendergrass, Shannon CMRS
Phone: (907) 355-0850

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 955730 Alaska

Profile Details

NPI number 1114269313
LBN Legal business name Odland Family Practice Clinic, Llc
DBA Doing business as
Authorized official Pendergrass, Shannon CMRS
Entity Organization
Organization subpart 1 No
Enumeration date Mar 26th, 2013
Last updated Mar 26th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114269313 NPPES
Alaska MEDICAID MD1574
Alaska MEDICAID MD9857

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