Organization
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Active
Other names
SEARHC WRANGELL MEDICAL CLINIC, SEARHC AICS Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL HARRIS (VP/CHIEF FINANCIAL OFFICER)
(907) 463-4000
Entity
Organization
Contact information
Practice address
232 WOOD STREET, STE 100, WRANGELL, AK 99929
(907) 874-4700
(907) 874-4719
Mailing address
3100 CHANNEL DRIVE STE 300, ATTN: PROVIDER ENROLLMENT, JUNEAU, AK 99801
(907) 463-4000
(907) 463-1510
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1663301
—
AK
01
—
70206
BUSINESS LICENSE
AK
Enumeration date
01/10/2017
Last updated
12/31/2020
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