Provider Demographics
NPI:1245605179
Name:NORTON SOUND HEALTH CORPORATION
Entity Type:Organization
Organization Name:NORTON SOUND HEALTH CORPORATION
Other - Org Name:ANNIKKAN INUIT ILUQUTAAT SUBREGIONAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY INFORMATIC SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TAHSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-443-3319
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:UNALAKLEET
Mailing Address - State:AK
Mailing Address - Zip Code:99684-0189
Mailing Address - Country:US
Mailing Address - Phone:907-624-3535
Mailing Address - Fax:
Practice Address - Street 1:189 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:UNALAKLEET
Practice Address - State:AK
Practice Address - Zip Code:99684-0189
Practice Address - Country:US
Practice Address - Phone:907-624-3535
Practice Address - Fax:907-624-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332800000X
AKPHAP2114333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157532OtherPK