Healthcare Provider Details

I. General information

NPI: 1619523156
Provider Name (Legal Business Name): INLET CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 N BINKLEY ST
SOLDOTNA AK
99669-7523
US

IV. Provider business mailing address

299 N BINKLEY ST
SOLDOTNA AK
99669-7523
US

V. Phone/Fax

Practice location:
  • Phone: 907-262-3800
  • Fax: 907-262-6429
Mailing address:
  • Phone: 907-262-3800
  • Fax: 907-262-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN RUFFRIDGE
Title or Position: DIRECTOR
Credential: PHARMD
Phone: 907-262-3800