Organization
BRISTOL BAY AREA HEALTH CORPORATION
Active
Other names
NAKNEK
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CLARK (CEO)
(907) 842-9502
Entity
Organization
Contact information
Practice address
192 MAIN STREET, NAKNEK, AK 99633
(907) 246-4214
(907) 842-9203
Mailing address
6000 KANAKANAK RD, PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-9400
(907) 842-9203
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
920044695
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020782
—
AK
01
—
TEZ156
MEDICARE ID-TYPE UNSPECIFIED
AK
Enumeration date
12/15/2006
Last updated
10/06/2023
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