Provider Demographics
NPI:1346571403
Name:EASTERN ALEUTIAN TRIBES, INC
Entity Type:Organization
Organization Name:EASTERN ALEUTIAN TRIBES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-277-1440
Mailing Address - Street 1:3380 C ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3949
Mailing Address - Country:US
Mailing Address - Phone:907-277-1440
Mailing Address - Fax:907-277-1446
Practice Address - Street 1:65 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:COLD BAY
Practice Address - State:AK
Practice Address - Zip Code:99571-0065
Practice Address - Country:US
Practice Address - Phone:907-532-2000
Practice Address - Fax:907-532-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health