Healthcare Provider Details

I. General information

NPI: 1871618926
Provider Name (Legal Business Name): NORTON SOUND HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W 5TH
NOME AK
99762
US

IV. Provider business mailing address

306 W 5TH
NOME AK
99762
US

V. Phone/Fax

Practice location:
  • Phone: 907-443-3311
  • Fax: 907-443-6411
Mailing address:
  • Phone: 907-443-3311
  • Fax: 907-443-6411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License NumberAA5050
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3045
License Number StateAK

VIII. Authorized Official

Name: ANGELA GORN
Title or Position: VP HOSPITAL SERVICES
Credential: MBA
Phone: 907-443-3311