Provider Demographics
NPI:1518955731
Name:WRANGELL MEDICAL CENTER
Entity Type:Organization
Organization Name:WRANGELL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHYMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-874-7000
Mailing Address - Street 1:PO BOX 1081
Mailing Address - Street 2:
Mailing Address - City:WRANGELL
Mailing Address - State:AK
Mailing Address - Zip Code:99929-1081
Mailing Address - Country:US
Mailing Address - Phone:907-874-7000
Mailing Address - Fax:907-874-7122
Practice Address - Street 1:310 BENNETT STREET
Practice Address - Street 2:
Practice Address - City:WRANGELL
Practice Address - State:AK
Practice Address - Zip Code:99929-1081
Practice Address - Country:US
Practice Address - Phone:907-874-7000
Practice Address - Fax:907-874-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKRPCH-003282NC0060X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1005585Medicaid
AK1020479Medicaid
AKHS06LTMedicaid
AKHS06OPMedicaid
AKHS06SBMedicaid
AK1005584Medicaid
AKHS06IPMedicaid
AK127OtherBLUE CROSS
AKMS5700Medicaid
AKHS06OPMedicaid
AK02Z305Medicare Oscar/Certification
AK1005584Medicaid
AK1005584Medicaid