Provider Demographics
NPI:1942368428
Name:YUKON KUSKOKWIM HEALTH CORP
Entity Type:Organization
Organization Name:YUKON KUSKOKWIM HEALTH CORP
Other - Org Name:AEROMED INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-543-6020
Mailing Address - Street 1:4700 BUSINESS PARK BLVD
Mailing Address - Street 2:E25
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7124
Mailing Address - Country:US
Mailing Address - Phone:907-677-7501
Mailing Address - Fax:907-677-7502
Practice Address - Street 1:4700 BUSINESS PARK BLVD
Practice Address - Street 2:E25
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7124
Practice Address - Country:US
Practice Address - Phone:907-677-7501
Practice Address - Fax:907-677-7502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YUKON KUSKOKWIM HEALTH CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3416A0800X, 3416L0300X
347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKAA0050Medicaid
AKAA5060Medicaid
AKTRO151Medicaid
AKAA5060Medicaid