Provider Demographics
NPI:1396063517
Name:CENTRAL PENINSULA HOSPITAL
Entity type:Organization
Organization Name:CENTRAL PENINSULA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, BSN, CWON, CFCN
Authorized Official - Prefix:MISS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-714-4874
Mailing Address - Street 1:PO BOX 853
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:AK
Mailing Address - Zip Code:99672-0853
Mailing Address - Country:US
Mailing Address - Phone:907-260-4031
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL PL
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7559
Practice Address - Country:US
Practice Address - Phone:907-714-4874
Practice Address - Fax:907-714-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital