Provider Demographics
NPI:1619704053
Name:SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Entity type:Organization
Organization Name:SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP/ CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-463-4000
Mailing Address - Street 1:3100 CHANNEL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7837
Mailing Address - Country:US
Mailing Address - Phone:907-463-4074
Mailing Address - Fax:907-463-1510
Practice Address - Street 1:9101 MENDENHALL MALL RD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7165
Practice Address - Country:US
Practice Address - Phone:907-463-0420
Practice Address - Fax:907-463-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK228664OtherLICENSURE