# CENTRAL PENINSULA GENERAL HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Central Peninsula Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770723967
- **Authorized official:** RICHARD DAVIS (CEO)
- **Authorized official phone:** (907) 714-4723

## Contact information

- **Practice address:** 506 LAKE ST, KENAI, AK 99611-6937
- **Practice address phone:** (907) 714-4030
- **Practice address fax:** (907) 335-0064
- **Mailing address:** 506 LAKE ST, KENAI, AK 99611-6937
- **Mailing address phone:** (907) 714-4030
- **Mailing address fax:** (907) 335-0064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 926294 | AK | Yes |
| 363A00000X | Physician Assistant | 926294 | AK | — |
| 363LF0000X | Family Nurse Practitioner | 926294 | AK | — |

## Other

- **Enumeration date:** 02/27/2009
- **Last updated:** 12/07/2020