1316016025 NPI number — CITY OF HOONAH

Table of content: (NPI 1316016025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316016025 NPI number — CITY OF HOONAH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF HOONAH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOONAH VOLUNTEER EMS
Provider Other Organization Name Type Code:
3
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:
1316016025
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3510
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVERDALE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98383-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-394-7010
Provider Business Mailing Address Fax Number:
360-394-7099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
375 HEMLOCK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOONAH
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99829-0360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-945-3663
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CITY ADMINISTRATOR
Authorized Official Telephone Number:
907-945-3663

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1608 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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