Provider Demographics
NPI:1891793048
Name:SITKA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SITKA COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-747-1764
Mailing Address - Street 1:209 MOLLER AVE
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7142
Mailing Address - Country:US
Mailing Address - Phone:907-747-3241
Mailing Address - Fax:907-747-1760
Practice Address - Street 1:209 MOLLER AVE
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7142
Practice Address - Country:US
Practice Address - Phone:907-747-3241
Practice Address - Fax:907-747-1760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF SITKA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-12
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKSITKA COMMUNITY HOSP251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMS0047Medicaid
AKHH0569Medicaid
AK027007Medicare ID - Type UnspecifiedMEDICARE HH