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General NPI Number Information
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NPI Number | 1396705539
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Entity Type | Organization
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Legal Business Name | PEACEHEALTH
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 3100 TONGASS AVE
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City | KETCHIKAN
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State | AK
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Zip | 99901-5746
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Country | US
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Telephone | 907-228-8300
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Fax | 907-228-8518
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Provider Business Mailing Address
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Address Line | PO BOX 1798
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City | BELLINGHAM
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State | WA
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Zip | 98227-1798
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Country | US
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Telephone | 360-734-5400
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Fax | 360-715-6552
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Authorized Official
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Title or Position | CEO
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Name | PATRICK J BRANCO
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Credential |
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Telephone | 907-228-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | NO NUMBER ASSIGNED
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License Number State | AK
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