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HEART OF EAGLE RIVER MEDICAL CLINIC NPI 1033277041


NPI Information

NPI: 1033277041
Provider Name: HEART OF EAGLE RIVER MEDICAL CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 02D0953917

Address:
11432 BUSINESS BLVD
SUITE 4
EAGLE RIVER, AK
ZIP 99577
Phone: (907) 694-1300
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HEART OF EAGLE RIVER MEDICAL CLINIC is a family medicine in Eagle River, AK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HEART OF EAGLE RIVER MEDICAL CLINIC NPI is 1033277041. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11432 BUSINESS BLVD
SUITE 4
EAGLE RIVER, AK
ZIP 99577-720
Phone: (907) 694-1300
Fax: (907) 694-1315

The provider's authorized official is Nancy J Holder .
The authorized official title is Billing Agent and has the following contact phone number (907) 694-1300.

The CLIA number assigned to this NPI record is 02D0953917 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/4/2006 and was last updated on 6/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERALASKATAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.