| Tribal - Port Alsworth Community Health Center | |
|
1 Flight Line Rd Port Alsworth AK 99653-9801 | |
| (907) 781-2256 | |
| Not Available |
| Full Name | Tribal - Port Alsworth Community Health Center |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1 Flight Line Rd, Port Alsworth, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tribal - Port Alsworth Community Health Center Po Box 35198 Seattle WA 98124-5198 | Tribal - Port Alsworth Community Health Center 1 Flight Line Rd Port Alsworth AK 99653-9801 Ph: (907) 781-2256 |
| NPI Number | 1770953903 |
|---|---|
| Provider Enumeration Date | 09/30/2015 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770953903 | NPI | - | NPPES |
| 1643081 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 20467 (Alaska) | Primary |