Organization
BRISTOL BAY AREA HEALTH CORPORATION
Active
Other names
KANAKANAK OUTPATIENT HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CLARK (CHIEF EXECUTIVE OFFICER)
(907) 842-6502
Entity
Organization
Contact information
Practice address
6000 KANAKANAK RD., DILLINGHAM, AK 99576-0130
(907) 842-9454
(907) 842-9203
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-9454
(907) 842-9203
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HS26OP
—
AK
01
—
TEZ010
MEDICARE ID - TYPE UNSPECIFIED
AK
Enumeration date
10/17/2006
Last updated
04/07/2011
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