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Organization
SOUTH PENINSULA HOSPITAL, INC
Active
Organization
SOUTH PENINSULA HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN SMITH (CHIEF EXECUTIVE OFFICER)
(907) 235-0241
Entity
Organization
Contact information
Practice address
4300 BARTLETT ST, HOMER, AK 99603-7005
(907) 235-8101
(907) 235-0253
Mailing address
4300 BARTLETT ST, HOMER, AK 99603-7005
(907) 235-8101
(907) 235-0253
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
275N00000X
Medicare Defined Swing Bed Hospital Unit
192072
AK
282N00000X
General Acute Care Hospital
—
—
282NC0060X
Critical Access Hospital
Primary
192072
AK
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005186
—
AK
05
—
1005653
—
AK
05
—
1005654
—
AK
05
—
1020634
—
AK
05
—
1028527
—
AK
05
—
1582637
—
AK
05
—
1582664
—
AK
05
—
1687514
—
AK
05
—
1687518
—
AK
05
—
1701931
—
AK
05
—
1738615
—
AK
05
—
1755753
—
AK
05
—
1756683
—
AK
Enumeration date
10/30/2008
Last updated
06/22/2026
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