| Edgar Nollner Health Center | |
|
30 Koyukuk Lane Koyukuk AK 99754-0030 | |
| (907) 927-2221 | |
| (907) 927-2211 |
| Full Name | Edgar Nollner Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 30 Koyukuk Lane, Koyukuk, 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 |
|---|---|
| Edgar Nollner Health Center 77 Antoski Avenue Galena AK 99741-0077 Ph: (907) 656-2366 | Edgar Nollner Health Center 30 Koyukuk Lane Koyukuk AK 99754-0030 Ph: (907) 927-2221 |
| NPI Number | 1568626760 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568626760 | NPI | - | NPPES |
| CL4429 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |