Organization
CITY OF KETCHIKAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E NEWELL JR. (FINANCE DIRECTOR)
(907) 225-3111
Entity
Organization
Contact information
Practice address
334 FRONT ST, KETCHIKAN, AK 99901-6431
(907) 225-3111
(907) 228-5608
Mailing address
PO BOX 3510, SILVERDALE, WA 98383-3510
(907) 225-3111
(907) 228-5608
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590003575
RAILROAD MEDICARE PTAN
—
05
—
TR0301
—
AK
Enumeration date
12/28/2006
Last updated
10/08/2012
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