Organization
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Active
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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