Healthcare Provider Details

I. General information

NPI: 1801919949
Provider Name (Legal Business Name): AIR SITKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 KATLIAN ST
SITKA AK
99835-7506
US

IV. Provider business mailing address

485 KATLIAN ST
SITKA AK
99835-7506
US

V. Phone/Fax

Practice location:
  • Phone: 907-747-7920
  • Fax: 907-747-6090
Mailing address:
  • Phone: 907-747-7920
  • Fax: 907-747-6090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number301160
License Number StateAK

VIII. Authorized Official

Name: MR. KENNETH ALAN BELLOWS
Title or Position: PRESIDENT
Credential:
Phone: 907-747-7920