Provider Demographics
NPI:1952348047
Name:GALEN HOSPITAL ALASKA, INC.
Entity Type:Organization
Organization Name:GALEN HOSPITAL ALASKA, INC.
Other - Org Name:ALASKA REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-264-1788
Mailing Address - Street 1:2801 DEBARR ROAD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2932
Mailing Address - Country:US
Mailing Address - Phone:907-276-1131
Mailing Address - Fax:907-264-1143
Practice Address - Street 1:2801 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2932
Practice Address - Country:US
Practice Address - Phone:907-276-1131
Practice Address - Fax:907-264-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3166600Medicaid
CAXHSP30568Medicaid
AK148OtherBLUE CROSS
AZ708612Medicaid
ID002124100Medicaid
OR292794Medicaid
AKHSP20Medicaid
UT=========008Medicaid
CAXHSP30568Medicaid
OR292794Medicaid