| Maniilaq Association | |
|
130 Casanoff Way Kiana AK 99749 | |
| (907) 442-3321 | |
| (907) 442-7250 |
| Full Name | Maniilaq Association |
|---|---|
| Speciality | Clinic/center |
| Location | 130 Casanoff Way, Kiana, Alaska |
| Authorized Official Name and Position | Gus Nelson (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 9074423321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maniilaq Association Po Box 43 Kotzebue AK 99752-0043 Ph: (907) 442-3321 | Maniilaq Association 130 Casanoff Way Kiana AK 99749 Ph: (907) 442-3321 |
| NPI Number | 1225784762 |
|---|---|
| Provider Enumeration Date | 02/23/2022 |
| Last Update Date | 03/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225784762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |