PEACEHEALTH NPI 1396705539

NPI Information

NPI: 1396705539
Provider Name: PEACEHEALTH

Doing Business As: KETCHIKAN MEDICAL CENTER

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
3100 TONGASS AVE
KETCHIKAN, AK
ZIP 99901
Phone: (907) 228-8300
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PEACEHEALTH is a critical access general acute care hospital in Ketchikan, AK. PEACEHEALTH NPI is 1396705539. The provider is registered as an organization entity type.
The provider Is Doing Business As Ketchikan Medical Center.

The provider's business location address is:

3100 TONGASS AVE
KETCHIKAN, AK
ZIP 99901-746
Phone: (907) 228-8300
Fax: (907) 228-8518

The provider's authorized official is Patrick J Branco .
The authorized official title is Ceo and has the following contact phone number (907) 228-8300.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 8/31/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	NO NUMBER ASSIGNED	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	021311	MEDICARE OSCAR/CERTIFICATION	ALASKA
2	HS04IP	MEDICAID	ALASKA
3	6110165	OTHER	ALASKA	AETNA FACILITY ID
4	0025	OTHER	ALASKA	TRICARE GROUP NUMBER
5	HS04OP	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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