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Organization
BRISTOL BAY AREA HEALTH CORPORATION
Active
Organization
BRISTOL BAY AREA HEALTH CORPORATION
Active
Other names
KANAKANAK OUTPATIENT HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CLARK (CHIEF EXECUTIVE OFFICER)
(907) 842-6502
Entity
Organization
Contact information
Practice address
6000 KANAKANAK RD., DILLINGHAM, AK 99576-0130
(907) 842-9454
(907) 842-9203
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-9454
(907) 842-9203
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HS26OP
—
AK
01
—
TEZ010
MEDICARE ID - TYPE UNSPECIFIED
AK
Enumeration date
10/17/2006
Last updated
04/07/2011
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