ADVANCED WELLNESS INFUSION CENTER LLC NPI 1366112856

NPI Information

NPI: 1366112856
Provider Name: ADVANCED WELLNESS INFUSION CENTER, LLC
Classification: Clinic/Center - 261QI0500X
Entity Type: Organization

Specialization: Infusion Therapy

Address:
5805 E COLUMBUS WAY
WASILLA, AK
ZIP 99654
Phone: (907) 929-4825
Get Directions

ADVANCED WELLNESS INFUSION CENTER, LLC is an infusion therapy clinic center in Wasilla, AK. ADVANCED WELLNESS INFUSION CENTER, LLC NPI is 1366112856. The provider is registered as an organization entity type.

The provider's business location address is:

5805 E COLUMBUS WAY
WASILLA, AK
ZIP 99654-831
Phone: (907) 929-4825

The provider's authorized official is Nathaniel L Eastman .
The authorized official title is Owner/provider and has the following contact phone number (907) 980-1186.

The enumeration date for this NPI number is 9/15/2021 and was last updated on 9/15/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QI0500X	Clinic/Center	Infusion Therapy			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MEDS5780	OTHER	ALASKA	STATE OF ALASKA MEDICAL LICENSE
2	BE8891649	OTHER	ALASKA	DEA

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

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »