| Southeast Alaska Regional Health Consortium | |
|
Cannery Site Excursion Inlet AK 99850 | |
| (907) 697-3008 | |
| Not Available |
| Full Name | Southeast Alaska Regional Health Consortium |
|---|---|
| Speciality | Clinic/center |
| Location | Cannery Site, Excursion Inlet, Alaska |
| Authorized Official Name and Position | Daniel Harris (VP/CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Alaska Regional Health Consortium 3100 Channel Drive Ste 300 Attn: Provider Enrollment Juneau AK 99801 Ph: (907) 463-4000 | Southeast Alaska Regional Health Consortium Cannery Site Excursion Inlet AK 99850 Ph: (907) 697-3008 |
| NPI Number | 1063958452 |
|---|---|
| Provider Enumeration Date | 01/10/2017 |
| Last Update Date | 12/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063958452 | NPI | - | NPPES |
| 70206 | Other | AK | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Alaska Island Community Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Fish Plant Way, Excursion Inlet, AK 99950 Phone: 907-697-3008 |