# YUKON KUSKOKWIM HEALTH CORPORATION

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

## Provider details

- **NPI number:** 1144818261
- **Authorized official:** CAROL ANN WILLARD (PROVIDER ENROLLMENT ADMINISTRATOR)
- **Authorized official phone:** (907) 543-6452

## Contact information

- **Practice address:** 269 MORGANS ROAD, ANIAK, AK 99557
- **Practice address phone:** (907) 543-6452
- **Mailing address:** BOX 3427, BETHEL, AK 99559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/05/2021
- **Last updated:** 01/05/2021