Organization Name: | PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA |
NPI Number: | 1124110796 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONNIE S. WINTERS (OFFICE MANAGER & A/R SUPERVISOR) |
Mailing Address: | 230 E Marydale Ave Suite 2 Soldotna |
State: | AK US |
Postal Code: | 996697648 |
Phone Number: | 9072603691 |
Fax Number: | 9072603697 |
NPI Enumeration Date: | 09/29/2006 |
NPI Last Update Date: | 09/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | 64033 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |