1275855736 NPI number — MS. SPRUCE MARGARET LYNCH ABHC

Table of content: MS. SPRUCE MARGARET LYNCH ABHC (NPI 1275855736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275855736 NPI number — MS. SPRUCE MARGARET LYNCH ABHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
SPRUCE
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ABHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275855736
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 966
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOME
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-443-3781
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6000 KANAKANAK ROAD
Provider Second Line Business Practice Location Address:
BRISTOL BAY AREA HEALTH CORPORATION
Provider Business Practice Location Address City Name:
DILLINGHAM
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-842-1230
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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