Provider Demographics
NPI:1063574200
Name:MUNICIPALITY OF SKAGWAY
Entity type:Organization
Organization Name:MUNICIPALITY OF SKAGWAY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-983-2255
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:SKAGWAY
Mailing Address - State:AK
Mailing Address - Zip Code:99840-0537
Mailing Address - Country:US
Mailing Address - Phone:907-983-2255
Mailing Address - Fax:907-983-2793
Practice Address - Street 1:350 14TH AVENUE
Practice Address - Street 2:
Practice Address - City:SKAGWAY
Practice Address - State:AK
Practice Address - Zip Code:99840
Practice Address - Country:US
Practice Address - Phone:907-983-2255
Practice Address - Fax:907-983-2793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK261Q00000X, 363LF0000X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK021836OtherMEDICARE FQHC
AK153026OtherMEDICARE PART B
AK1029911Medicaid
AK1029911Medicaid