MT SANFORD TRIBAL CONSORTIUM NPI 1427104959

NPI Information

NPI: 1427104959
Provider Name: MT SANFORD TRIBAL CONSORTIUM
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 02D0911413

Address:
MILE POST 33 TOK CUTOFF
CHISTOCHINA, AK
ZIP 99586
Phone: (907) 822-3280
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MT SANFORD TRIBAL CONSORTIUM is a community health clinic center in Chistochina, AK. MT SANFORD TRIBAL CONSORTIUM NPI is 1427104959. The provider is registered as an organization entity type.

The provider's business location address is:

MILE POST 33 TOK CUTOFF
CHISTOCHINA, AK
ZIP 99586-357
Phone: (907) 822-3280
Fax: (907) 822-3944

The provider's authorized official is George Thomas Drinkwater .
The authorized official title is Chap Clinic Director and has the following contact phone number (907) 822-5399.

The CLIA number assigned to this NPI record is 02D0911413 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 3/2/2011.

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	261QC1500X	Clinic/Center	Community Health			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	CL0143	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: 5/5/2024

NPI Synchronization or Removal

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