ILANKA COMMUNITY HEALTH CENTER (NATIVE VILLAGE OF EYAK) NPI 1134471287

Clinic/Center in Cordova, AK

NPI 1134471287 Organization Clinic/Center CLIA Number 02D0971851 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About ILANKA COMMUNITY HEALTH CENTER (NATIVE VILLAGE OF EYAK)

Ilanka Community Health Center (native Village Of Eyak) is a provider established in Cordova, Alaska specializing in clinic/center. The NPI number of Ilanka Community Health Center (native Village Of Eyak) is 1134471287 and was assigned on October 2012. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Ilanka Community Health Center. The authorized official of this NPI record is Penney Benson (Administrator)

The CLIA number of Ilanka Community Health Center is 02D0971851 registered as a "community clinic" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Ilanka Community Health Center in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1134471287

Provider NameILANKA COMMUNITY HEALTH CENTER (NATIVE VILLAGE OF EYAK)
Provider Location Address705 SECOND ST CORDOVA, AK 99574
Provider Mailing AddressPO BOX 196720 ANCHORAGE, AK 99519
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameILANKA COMMUNITY HEALTH CENTER
Other Name TypeDoing Business As (3)
Enumeration Date10-12-2012
Last Update Date05-27-2020


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
License StateAK
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

ILANKA COMMUNITY HEALTH CENTER
705 SECOND ST
CORDOVA, AK
ZIP 99574
Phone: (907) 424-3622

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Mailing Address

ILANKA COMMUNITY HEALTH CENTER
PO BOX 196720
ANCHORAGE, AK
ZIP 99519
Phone: (907) 424-3622



Authorized Official

Authorized Official Name PENNEY BENSON
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(907) 424-3622

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1134471287 is:

CLIA Number02D0971851
Facility TypeCOMMUNITY CLINIC
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821074535NATIVE VILLAGE OF EYAK
Organization
Clinic/Center (Community Health)705 SECOND ST
CORONA, AK 99574
(907) 424-3622

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.