# MYRA ROBERTS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063602563
- **Authorized official:** MELINDA PETER (HEALTH DIRECTOR)
- **Authorized official phone:** (907) 662-7529

## Contact information

- **Practice address:** 81060 MAIN STREET, VENETIE, AK 99740-0060
- **Practice address phone:** (907) 849-8712
- **Practice address fax:** (907) 849-8915
- **Mailing address:** P.O. BOX 81060, VENETIE, AK 99740-0060
- **Mailing address phone:** (907) 849-8712
- **Mailing address fax:** (907) 849-8915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/31/2007
- **Last updated:** 11/21/2018