Provider Demographics
NPI:1831255421
Name:BRISTOL BAY AREA HEALTH CORPORATION
Entity type:Organization
Organization Name:BRISTOL BAY AREA HEALTH CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-842-9502
Mailing Address - Street 1:6000 KANAKANAK RD
Mailing Address - Street 2:P O BOX 130
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576
Mailing Address - Country:US
Mailing Address - Phone:907-842-6400
Mailing Address - Fax:907-842-9203
Practice Address - Street 1:6000 KANAKANAK RD
Practice Address - Street 2:
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576
Practice Address - Country:US
Practice Address - Phone:907-842-6400
Practice Address - Fax:907-842-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access