Koliganek Clinic | |
5060 Main Street Koliganek AK 99576 | |
(907) 842-5201 | |
(907) 842-9250 |
Full Name | Koliganek Clinic |
---|---|
Speciality | Clinic/center |
Location | 5060 Main Street, Koliganek, Alaska |
Authorized Official Name and Position | Robert Clark (CEO) |
Authorized Official Contact | 9078425201 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Koliganek Clinic Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Koliganek Clinic 5060 Main Street Koliganek AK 99576 Ph: (907) 842-5201 |
NPI Number | 1013079607 |
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Provider Enumeration Date | 12/14/2006 |
Last Update Date | 10/06/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013079607 | NPI | - | NPPES |
1020782 | Medicaid | AK | |
TEZ153 | Other | AK | MEDICARE ID-TYPE UNSPECIFIED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |