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Organization

BETHEL FAMILY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZANNE NIEMI (FINANCE)
(907) 543-9852
Entity
Organization

Contact information

Practice address
631 MAIN STREET, BETHEL, AK 99559-1908
(907) 543-3773
(907) 543-3545
Mailing address
PO BOX 1908, 631 MAIN STREET, BETHEL, AK 99559-1908
(907) 543-3773
(907) 543-3545

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02-1835
MEDICARE PART A PTAN
AK
05
1029936
AK
Enumeration date
05/11/2006
Last updated
11/27/2018
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