Bristol Bay Area Health Corporation
Organization Active NPI Critical Access Hospital · Dillingham, AK
NPI 1831255421 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1831255421
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- BRISTOL BAY AREA HEALTH CORPORATION
- Practice address
- 6000 Kanakanak Rd
Dillingham, AK 99576 - Phone
- (907) 842-6400
- Fax
- (907) 842-9203
- NPI assigned
- Dec 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Clark
- Title
- Ceo
- Phone
- (907) 842-9502
Other NPIs on the same Medicare enrollment 38
Corporate family (same tax ID) 41
Practitioners 20
-
Marc B Connelly, MD
-
Mario Cruz, OD
-
Barbara L Riley, MD
-
Prabhat Kumar Bhama, MD, MPH, FACS
-
James Bozeman, PMHNP-BC
-
Andrina Lee Brantley, LCSWA
-
Siobhan Katherine Cooper, M.D., MPH
-
Allison Lee Demany, DMSC, PA-C
-
James Michael Lesniak, PA-C
-
John Bradford Lichlyter, MSN, APRN, NP-C, CEN
-
Eric K Lim, MD
-
Joshua David Ring, M.D.
-
Tevin Trinh, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031120000998 | TX | Part B Supplier - Clinic/Group Practice | 5890699920 |
Receives reassigned benefits from 432 practitioners 44 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lebelock, AK; Manokotak, AK; Goodnews Bay, AK; Naknek, AK; New Stuyahok, AK; Perryville, AK; Pilot Point, AK; Platinum, AK… |
National Provider Directory
- Tax ID family
- Bristol Bay Area HLTH Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
6000 Kanakanak Rd
Dillingham, AK 99576
Mailing address
6000 Kanakanak Rd
P O Box 130
Dillingham, AK 99576
Phone (907) 842-6400
Other names
- KANAKANAK HOSPITAL
Other providers in Dillingham, AK
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Area Health Corporation
- Bristol Bay Native Association
All providers in Dillingham, AK · Critical Access Hospital in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.