Provider Demographics
NPI:1477909067
Name:BARTLETT REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:BARTLETT REGIONAL HOSPITAL
Other - Org Name:BARTLETT MEDICAL ONCOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WANNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-796-8402
Mailing Address - Street 1:1701 SALMON CREEK LN
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7868
Mailing Address - Country:US
Mailing Address - Phone:907-796-8773
Mailing Address - Fax:907-796-8728
Practice Address - Street 1:1701 SALMON CREEK LN
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7868
Practice Address - Country:US
Practice Address - Phone:907-796-8773
Practice Address - Fax:907-796-8728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty