Provider Demographics
NPI:1154452878
Name:SITKA MEDICAL CENTER
Entity type:Organization
Organization Name:SITKA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-747-5861
Mailing Address - Street 1:700 KATLIAN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7359
Mailing Address - Country:US
Mailing Address - Phone:907-747-5861
Mailing Address - Fax:907-747-5415
Practice Address - Street 1:700 KATLIAN ST STE E
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7359
Practice Address - Country:US
Practice Address - Phone:907-747-5861
Practice Address - Fax:907-747-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK483103TC0700X
AK118937261QP2300X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1004397Medicaid
AKK0000WCJCRMedicare PIN
AK1004397Medicaid