Edgar Nollner Health Center | |
148 Katido Street Kaltag AK 99748-0148 | |
(907) 534-2209 | |
(907) 534-2216 |
Full Name | Edgar Nollner Health Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 148 Katido Street, Kaltag, Alaska |
Authorized Official Name and Position | Cathy Anne Desanto (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9076562366 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Edgar Nollner Health Center 77 Antoski Avenue Galena AK 99741-0077 Ph: (907) 656-2366 | Edgar Nollner Health Center 148 Katido Street Kaltag AK 99748-0148 Ph: (907) 534-2209 |
NPI Number | 1669636866 |
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Provider Enumeration Date | 07/16/2008 |
Last Update Date | 07/16/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669636866 | NPI | - | NPPES |
CL4429 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |