Edgar Nollner Helath Center | |
74 Ruby Road Ruby AK 99768-0074 | |
(907) 468-4433 | |
(907) 468-4411 |
Full Name | Edgar Nollner Helath Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 74 Ruby Road, Ruby, 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 Helath Center 77 Antoski Avenue Galena AK 99741-0077 Ph: (907) 656-2366 | Edgar Nollner Helath Center 74 Ruby Road Ruby AK 99768-0074 Ph: (907) 468-4433 |
NPI Number | 1487818639 |
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Provider Enumeration Date | 07/17/2008 |
Last Update Date | 07/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487818639 | NPI | - | NPPES |
CL4429 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |