Organization
CHUGACH EYE CLINIC AND OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL E HAGGE OD (PRESIDENT, OWNER)
(907) 694-2020
Entity
Organization
Contact information
Practice address
10928 EAGLE RIVER RD STE 102, EAGLE RIVER, AK 99577-8078
(907) 694-2020
(907) 694-5989
Mailing address
10928 EAGLE RIVER RD STE 102, EAGLE RIVER, AK 99577-8078
(907) 694-2020
(907) 694-5989
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
95
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400601400601
BLUE CROSS BLUE SHIELD #
AK
05
—
OP0095
—
AK
Enumeration date
05/09/2007
Last updated
08/22/2020
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