| Girdwood Health Clinic, Inc. | |
|
131 Lindblad Avenue Girdwood AK 99587 | |
| (907) 783-1355 | |
| (907) 783-1357 |
| Full Name | Girdwood Health Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 131 Lindblad Avenue, Girdwood, Alaska |
| Authorized Official Name and Position | Suzanne Niemi (CFO) |
| Authorized Official Contact | 9077831355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Girdwood Health Clinic, Inc. Po Box 1130 Girdwood AK 99587-1130 Ph: (907) 783-1355 | Girdwood Health Clinic, Inc. 131 Lindblad Avenue Girdwood AK 99587 Ph: (907) 783-1355 |
| NPI Number | 1851662233 |
|---|---|
| Provider Enumeration Date | 01/18/2012 |
| Last Update Date | 12/20/2022 |
| Medicare PECOS PAC ID | 4688836216 |
|---|---|
| Medicare Enrollment ID | O20120427000146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851662233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Alaska) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Erin L Lester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962723494 PECOS PAC ID: 8527211085 Enrollment ID: I20131119000516 |
| Provider Name | Martha F Rosenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871946780 PECOS PAC ID: 7416243936 Enrollment ID: I20160909001374 |
| Provider Name | John M Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386196111 PECOS PAC ID: 8123308004 Enrollment ID: I20161212000646 |
| Provider Name | Shoshannah S Kinsler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760912828 PECOS PAC ID: 2567724560 Enrollment ID: I20180402000632 |
| Provider Name | Jonathon Edward Blum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558928580 PECOS PAC ID: 7012329154 Enrollment ID: I20201215001936 |
| Provider Name | Andrew Harlos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306120365 PECOS PAC ID: 5395269617 Enrollment ID: I20250408003090 |