Healthcare Provider Details

I. General information

NPI: 1477684561
Provider Name (Legal Business Name): KACHEMAK BAY FAMILY PLANNING CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BEN WALTERS LN
HOMER AK
99603-7707
US

IV. Provider business mailing address

3959 BEN WALTERS LN
HOMER AK
99603-7707
US

V. Phone/Fax

Practice location:
  • Phone: 907-235-3436
  • Fax: 907-235-8346
Mailing address:
  • Phone: 907-235-3436
  • Fax: 907-235-8346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA HAINES
Title or Position: CEO
Credential:
Phone: 907-235-3436