Provider Demographics
NPI:1265023725
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:FAUSTINE
Authorized Official - Last Name:GORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-443-3286
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3111
Mailing Address - Fax:
Practice Address - Street 1:1ST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SHAKTOOLIK
Practice Address - State:AK
Practice Address - Zip Code:99771
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON SOUND HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)