| Searhc Gustavus Clinic | |
|
42 Dolly Varden Lane Gustavus AK 99826 | |
| (907) 697-3008 | |
| (907) 697-3034 |
| Full Name | Searhc Gustavus Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 42 Dolly Varden Lane, Gustavus, Alaska |
| Authorized Official Name and Position | Daniel Harris (VP/CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Searhc Gustavus Clinic 3100 Channel Drive Ste 300 Attn: Provider Enrollment Juneau AK 99801 Ph: (907) 463-4000 | Searhc Gustavus Clinic 42 Dolly Varden Lane Gustavus AK 99826 Ph: (907) 697-3008 |
| NPI Number | 1649716226 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 02/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649716226 | NPI | - | NPPES |
| 1663291 | Medicaid | AK | |
| 70206 | Other | AK | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
Alaska Island Community Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 42 Dolly Varden Rd, Gustavus, AK 99826 Phone: 907-697-3008 Fax: 907-697-3034 |