# BRISTOL BAY AREA HEALTH CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KANAKANAK PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336272095
- **Authorized official:** MR. ROBERT J CLARK (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (907) 842-5201

## Contact information

- **Practice address:** 6000 KANAKANAK ROAD, DILLINGHAM, AK 99576
- **Practice address phone:** (907) 842-5201
- **Practice address fax:** (907) 842-9250
- **Mailing address:** PO BOX 130, DILLINGHAM, AK 99576-0130
- **Mailing address phone:** (907) 842-5201
- **Mailing address fax:** (904) 842-9250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 345 | AK | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0202123 | NABP | — |
| 05 | — | PH0067 | — | AK |