City of Bethel

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

AA0120 Issued in AK

Legal business name

CITY OF BETHEL

Practice address

320 Chief Eddie Hoffman Hwy
Bethel, AK 99559

Phone

(907) 543-2131

Fax

(907) 543-2702

NPI assigned

Mar 1, 2007

Last updated

Mar 1, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eric Johnson

Title

Assistant Finance Director

Phone

(907) 543-1375

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1619005683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995591388",
            "telephone_number": "907-543-1375",
            "fax_number": "907-543-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CHIEF EDDIE HOFFMAN HWY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-2131",
            "fax_number": "907-543-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BETHEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "ASSISTANT FINANCE DIRECTOR",
        "authorized_official_telephone_number": "907-543-1375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AK",
            "license": "AA0120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TR0217",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber G Chung
• Michael Chung
• Carol Church
• Mien Chyi, M.D.
• Alan Louis Cirocco, LICSW
• Daniel Clark Sr.
• Janet Clark
• Henrietta A Coffee, CHA
• Elda G. Coffey, ANP
• Eddie Collins

• Land Ambulance in Bethel, AK
• Providers in Bethel, AK by specialty
• Land Ambulance in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.