Provider Demographics
NPI:1629198403
Name:NORTON SOUND HEALTH CORP
Entity Type:Organization
Organization Name:NORTON SOUND HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V P HOSPITAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-443-3311
Mailing Address - Street 1:NSHC
Mailing Address - Street 2:P O BOX 966
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-6412
Practice Address - Street 1:306 W 5TH STREET
Practice Address - Street 2:NSHC
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:907-443-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKHS21LT313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHS21LTMedicaid