Healthcare Provider Details

I. General information

NPI: 1902342306
Provider Name (Legal Business Name): SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 WOOD STREET
WRANGELL AK
99929-9992
US

IV. Provider business mailing address

3100 CHANNEL DRIVE
JUNEAU AK
99801
US

V. Phone/Fax

Practice location:
  • Phone: 907-874-8347
  • Fax: 907-874-2352
Mailing address:
  • Phone: 907-463-4074
  • Fax: 907-463-1510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL HARRIS
Title or Position: VP/CHIEF FINANCIAL OFFICER
Credential:
Phone: 907-463-4000