Provider Demographics
NPI:1649403379
Name:TANANA TRIBAL COUNCIL
Entity Type:Organization
Organization Name:TANANA TRIBAL COUNCIL
Other - Org Name:TANANA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TRITCHLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:907-366-7222
Mailing Address - Street 1:PO BOX 77150
Mailing Address - Street 2:
Mailing Address - City:TANANA
Mailing Address - State:AK
Mailing Address - Zip Code:99777-0150
Mailing Address - Country:US
Mailing Address - Phone:907-366-7222
Mailing Address - Fax:907-366-7249
Practice Address - Street 1:101 FIRST STREET
Practice Address - Street 2:
Practice Address - City:TANANA
Practice Address - State:AK
Practice Address - Zip Code:99777
Practice Address - Country:US
Practice Address - Phone:907-366-7222
Practice Address - Fax:907-366-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care