Provider Demographics
NPI:1306484332
Name:URGENT CARE OF SOLDOTNA INC.
Entity type:Organization
Organization Name:URGENT CARE OF SOLDOTNA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEOFFREY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:LANFEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-C
Authorized Official - Phone:406-407-3126
Mailing Address - Street 1:44604 STERLING HWY STE D
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7962
Mailing Address - Country:US
Mailing Address - Phone:406-407-3126
Mailing Address - Fax:
Practice Address - Street 1:44604 STERLING HWY STE D
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7962
Practice Address - Country:US
Practice Address - Phone:406-407-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care