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General NPI Number Information
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NPI Number | 1962616821
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Entity Type | Organization
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Legal Business Name | SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 100 CLINIC WAY
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City | KASAAN
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State | AK
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Zip | 99950-0340
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Country | US
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Telephone | 907-542-2222
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Fax | 907-542-2225
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Provider Business Mailing Address
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Address Line | 3100 CHANNEL DR STE 300
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City | JUNEAU
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State | AK
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Zip | 99801-7837
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Country | US
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Telephone | 907-463-4074
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Fax | 907-463-1510
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. DANIEL HARRIS
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Credential |
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Telephone | 907-463-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 70206
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License Number State | AK
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