Basic Information
| Provider Information | |||||||||
| NPI: | 1841540929 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEARHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 69 | ||||||||
| Address2: | |||||||||
| City: | KLAWOCK | ||||||||
| State: | AK | ||||||||
| PostalCode: | 999250069 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1305 CRAIG KLOWACK HWY | ||||||||
| Address2: | |||||||||
| City: | KLOWACK | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077554800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2012 | ||||||||
| LastUpdateDate: | 09/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | RYAN | ||||||||
| AuthorizedOfficialFirstName: | PETE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 9077554800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.