Healthcare Provider Details

I. General information

NPI: 1851921118
Provider Name (Legal Business Name): BARTLETT REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 HOSPITAL DR
JUNEAU AK
99801-7808
US

IV. Provider business mailing address

3260 HOSPITAL DR
JUNEAU AK
99801-7808
US

V. Phone/Fax

Practice location:
  • Phone: 907-796-8498
  • Fax: 907-796-8497
Mailing address:
  • Phone: 907-796-8498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WANNER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 907-796-8900