Provider Demographics
NPI:1184850893
Name:NORTON SOUND HEALTH CORPORATION
Entity Type:Organization
Organization Name:NORTON SOUND HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-443-3286
Mailing Address - Street 1:P O BOX 966
Mailing Address - Street 2:1000 GREG KRUSCHEK AVE
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-3723
Practice Address - Street 1:1000 GREG KRUSCHEK AVE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:907-443-3723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON SOUND HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-09
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK155538275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK02Z308Medicare Oscar/Certification