Bristol Bay Area Health Corporation
Clinic/Center in New Stuyahok, AK. Organization (NPI-2).
NPI number1720148976
StatusActive
Last updated in NPPESOct 6, 2023
Details
- NPI
- 1720148976
- Entity type
- Organization (NPI-2)
- Legal business name
- Bristol Bay Area Health Corporation
- Organization subpart
- No
- Enumeration date
- Dec 11, 2006
- Certification date
- Oct 5, 2023
- Last updated
- Oct 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- New Stuyahok Clinic (Other Name)
Practice location
109 Main StreetNew Stuyahok, AK 99636
Phone 907-842-5201 · Fax 907-842-9250
Mailing address
Po Box 130Dillingham, AK 99576-0130
Phone 907-842-5201 · Fax 907-842-9250
Authorized official
Cathy Leeann Taylor
Provider Enrollment Specialist
9078425201
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