=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992033153
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTRAL PENINSULA GENERAL HOSPITAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2009
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 240 HOSPITAL PL
-----------------------------------------------------
City | SOLDOTNA
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-714-4090
-----------------------------------------------------
Fax | 907-714-4697
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 250 HOSPITAL PL
-----------------------------------------------------
City | SOLDOTNA
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99669-7559
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-714-4090
-----------------------------------------------------
Fax | 907-714-4697
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SHAUN KEEF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 907-714-4719
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NR1301X
-----------------------------------------------------
Taxonomy Name | Rural Acute Care Hospital
-----------------------------------------------------
License Number | 937106
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 937106
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------