Healthcare Provider Details

I. General information

NPI: 1780085381
Provider Name (Legal Business Name): SITKA COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 MOLLER AVE
SITKA AK
99835-7142
US

IV. Provider business mailing address

209 MOLLER AVE
SITKA AK
99835-7142
US

V. Phone/Fax

Practice location:
  • Phone: 907-747-3241
  • Fax: 907-747-0351
Mailing address:
  • Phone: 907-747-3241
  • Fax: 907-747-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateAK

VIII. Authorized Official

Name: LEE BENNETT
Title or Position: CFO
Credential:
Phone: 907-747-1764