Healthcare Provider Details

I. General information

NPI: 1992033153
Provider Name (Legal Business Name): CENTRAL PENINSULA GENERAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 09/02/2025
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 HOSPITAL PL
SOLDOTNA AK
99669
US

IV. Provider business mailing address

250 HOSPITAL PL
SOLDOTNA AK
99669-7559
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4090
  • Fax: 907-714-4697
Mailing address:
  • Phone: 907-714-4090
  • Fax: 907-714-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number937106
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number937106
License Number StateAK

VIII. Authorized Official

Name: SHAUN KEEF
Title or Position: CEO
Credential:
Phone: 907-714-4719