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NPI Code Detail

MEDICARE: CENTRAL PENINSULA GENERAL HOSPITAL INC

MEDICARE: CENTRAL PENINSULA GENERAL HOSPITAL INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant926294AK
2363LF0000XFamily Nurse Practitioner926294AK
3282NR1301XRural Acute Care Hospital926294AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10004OTHERAKTRICARE
2155OTHERAKBLUE CROSS

General Provider Information

NPI Number : 1770723967
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL PENINSULA GENERAL HOSPITAL INC
Provider Business Mailing Address
First Line : 506 LAKE ST
Second Line :
City : KENAI
State : AK
Zip : 99611-6937
Country : US
Telephone Number : 907-714-4030
Fax Number : 907-335-0064
Provider Business Practice Location Address
First Line : 506 LAKE ST
Second Line :
City : KENAI
State : AK
Zip : 99611-6937
Country : US
Telephone Number : 907-714-4030
Fax Number : 907-335-0064
Authorized Official
Title or Position : CEO
Name : RICHARD DAVIS
Credential :
Telephone Number : 907-714-4723
Provider Enumeration Date : 02/27/2009
Last Update Date : 12/07/2020

Similar Medicare Providers

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Practice Location Address:
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99611-6937
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1225048648 — MICHAEL K VISICK MD
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Practice Phone: 907-714-4111
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1497809669 — DR. KEVIN ARTHUR RULLMAN DO
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1104951300 — LINDA MAY PERRY LCSW
Practice Location Address:
506 LAKE ST
KENAI, AK
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1922444009 — JOANNA FRANCIS GIBBONS M.D.
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1962870790 — HEATHER RENEE BEYERS WHNP/PMHNP
Practice Location Address:
502 LAKE ST
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Practice Phone: 907-600-1684
Practice Fax: 907-308-5882

Directions to “CENTRAL PENINSULA GENERAL HOSPITAL INC ” Practice Location

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