Healthcare Provider Details

I. General information

NPI: 1831404805
Provider Name (Legal Business Name): CENTRAL PENINSULA GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N BINKLEY ST SUITE 101
SOLDOTNA AK
99669-7523
US

IV. Provider business mailing address

250 HOSPITAL PL
SOLDOTNA AK
99669-7559
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4111
  • Fax: 907-714-4696
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. RICK DAVIS
Title or Position: CEO
Credential:
Phone: 907-714-4723