Provider Demographics
NPI:1053058438
Name:NINILCHIK VILLAGE TRIBAL COUNCIL
Entity Type:Organization
Organization Name:NINILCHIK VILLAGE TRIBAL COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRIBAL HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-567-3370
Mailing Address - Street 1:PO BOX 39368
Mailing Address - Street 2:
Mailing Address - City:NINILCHIK
Mailing Address - State:AK
Mailing Address - Zip Code:99639-0368
Mailing Address - Country:US
Mailing Address - Phone:907-567-3370
Mailing Address - Fax:
Practice Address - Street 1:33880 STERLING HIGHWAY
Practice Address - Street 2:
Practice Address - City:ANCHOR POINT
Practice Address - State:AK
Practice Address - Zip Code:99556
Practice Address - Country:US
Practice Address - Phone:907-206-2733
Practice Address - Fax:907-907-2355
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NINILCHIK VILLAGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health