Healthcare Provider Details

I. General information

NPI: 1063567691
Provider Name (Legal Business Name): YUKON-KUSKOKWIM HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHIEF EDDIE HOFFMAN HWY
BETHEL AK
99559
US

IV. Provider business mailing address

PO BOX 528
BETHEL AK
99559-0528
US

V. Phone/Fax

Practice location:
  • Phone: 907-543-6300
  • Fax: 907-543-6006
Mailing address:
  • Phone: 907-543-6000
  • Fax: 907-543-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number121742
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberFEDERAL SITE
License Number State

VIII. Authorized Official

Name: MR. DANIEL WINKELMAN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 907-543-6032