Provider Demographics
NPI:1588865455
Name:NORTON SOUND HEALTH CORPORATION
Entity type:Organization
Organization Name:NORTON SOUND HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PANIPTCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:CHP
Authorized Official - Phone:907-443-3344
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3344
Mailing Address - Fax:907-443-5915
Practice Address - Street 1:306 W 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3344
Practice Address - Fax:907-443-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMH0212251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH0212Medicaid