Provider Demographics
NPI:1184616476
Name:IMMEDIATE CARE INC
Entity type:Organization
Organization Name:IMMEDIATE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GREENIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-336-3365
Mailing Address - Street 1:403 W NORTHERN LIGHTS BLVD
Mailing Address - Street 2:STE 4
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2502
Mailing Address - Country:US
Mailing Address - Phone:907-277-0042
Mailing Address - Fax:907-277-0049
Practice Address - Street 1:403 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:STE 4
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2502
Practice Address - Country:US
Practice Address - Phone:907-277-0042
Practice Address - Fax:907-277-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK027031251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
3310366742OtherTAX ID
AKHH2031Medicaid
AK027031Medicare ID - Type Unspecified