Organization
MT SANFORD TRIBAL CONSORTIUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE THOMAS DRINKWATER (CHAP CLINIC DIRECTOR)
(907) 822-5399
Entity
Organization
Contact information
Practice address
MILE POST 33 TOK CUTOFF, CHISTOCHINA, AK 99586-0357
(907) 822-3280
(907) 822-3944
Mailing address
PO BOX 357, GAKONA, AK 99586-0357
(907) 822-5399
(907) 822-5810
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL0143
—
AK
Enumeration date
01/26/2007
Last updated
03/02/2011
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