Organization
BETHEL FAMILY CLINIC
Active
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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