Provider Demographics
NPI:1497113625
Name:PROVIDENCE ALASKA MEDICAL CENTER
Entity Type:Organization
Organization Name:PROVIDENCE ALASKA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DHARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:907-212-4974
Mailing Address - Street 1:22568 SAMBAR LOOP
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-5377
Mailing Address - Country:US
Mailing Address - Phone:907-212-4974
Mailing Address - Fax:
Practice Address - Street 1:22568 SAMBAR LOOP
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5377
Practice Address - Country:US
Practice Address - Phone:907-212-4974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital