Organization
BRISTOL BAY AREA HEALTH CORPORATION
Active
Other names
KOLIGANEK CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CLARK (CEO)
(907) 842-5201
Entity
Organization
Contact information
Practice address
5060 MAIN STREET, KOLIGANEK, AK 99576
(907) 842-5201
(907) 842-9250
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-5201
(907) 842-9250
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020782
—
AK
01
—
TEZ153
MEDICARE ID-TYPE UNSPECIFIED
AK
Enumeration date
12/14/2006
Last updated
10/06/2023
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