Basic Information
| Provider Information | |||||||||
| NPI: | 1154755056 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEGICH SCHOOL BASED HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1825 ACADEMY DR | ||||||||
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| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995075391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075227090 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7440 CREEKSIDE CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995045234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077702380 | ||||||||
| FaxNumber: | 9077702341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2013 | ||||||||
| LastUpdateDate: | 08/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | BEATY | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING AGENT | ||||||||
| AuthorizedOfficialTelephone: | 9077702380 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CHRISTIAN HEALTH ASSOCIATES | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 188405 | AK | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.