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NPI Code Detail

MEDICARE: THE PETERSBURG MEDICAL CENTER

MEDICARE: THE PETERSBURG MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QA0600XAdult Day Care Clinic/Center
3282NC0060XCritical Access HospitalAK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437122843
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PETERSBURG MEDICAL CENTER
Provider Business Mailing Address
First Line : PO BOX 589
Second Line :
City : PETERSBURG
State : AK
Zip : 99833-0589
Country : US
Telephone Number : 907-772-4291
Fax Number : 907-772-3085
Provider Business Practice Location Address
First Line : 103 FRAM STREET
Second Line :
City : PETERSBURG
State : AK
Zip : 99833-0589
Country : US
Telephone Number : 907-772-4291
Fax Number : 907-772-3085
Authorized Official
Title or Position : CEO
Name : PHILIP J HOFSTETTER
Credential : AUD
Telephone Number : 907-772-4291
Provider Enumeration Date : 02/08/2006
Last Update Date : 12/19/2023

Similar Medicare Providers

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103 FRAM STREET
PETERSBURG, AK
99833-0589
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1902909542 — SHARON M HUNTER RN
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1376641092 — MARGARET D FLEMING MS,RD,LD
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PETERSBURG, AK
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1639237159 — PETERSBURG MEDICAL CENTER
Practice Location Address:
103 FRAM STREET
PETERSBURG, AK
99833-0589
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1104984954 — THE PETERSBURG MEDICAL CENTER
Practice Location Address:
103 FRAM STREET
PETERSBURG, AK
99833-0589
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1790844033 — THE PETERSBURG MEDICAL CENTER
Practice Location Address:
103 FRAM STREET
PETERSBURG, AK
99833-0589
Practice Phone: 907-772-4291
Practice Fax: 907-772-3085

Directions to “THE PETERSBURG MEDICAL CENTER ” Practice Location

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