SAMUEL SIMMONDS MEMORIAL HOSPITAL NPI 1578758744

General Acute Care Hospital (Critical Access) in Barrow, AK

NPI 1578758744 Organization General Acute Care Hospital Critical Access CLIA Number 02D0641844 CLIA Certificate of Accreditation

About SAMUEL SIMMONDS MEMORIAL HOSPITAL

Samuel Simmonds Memorial Hospital is a provider established in Barrow, Alaska specializing in general acute care hospital (critical access) . The NPI number of Samuel Simmonds Memorial Hospital is 1578758744 and was assigned on September 2007. The practitioner's primary taxonomy code is 282NC0060X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mr. Cathy Wolfe (Director Of Nursing)

The CLIA number of Samuel Simmonds Memorial Hospital is 02D0641844 registered as a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued to Samuel Simmonds Memorial Hospital on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI

1578758744

Provider NameSAMUEL SIMMONDS MEMORIAL HOSPITAL
Provider Location Address1296 AGVIK STREET BARROW, AK 99723
Provider Mailing AddressPO BOX 29 BARROW, AK 99723
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-11-2007
Last Update Date04-20-2008


Primary Taxonomy

Taxonomy Code282NC0060X
ClassificationGeneral Acute Care Hospital
TypeHospitals
SpecializationCritical Access
License StateAK
Taxonomy DescriptionDefinition to come.

Business Address

SAMUEL SIMMONDS MEMORIAL HOSPITAL
1296 AGVIK STREET
BARROW, AK
ZIP 99723
Phone: (907) 852-4611
Fax: (907) 852-2163

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Mailing Address

SAMUEL SIMMONDS MEMORIAL HOSPITAL
PO BOX 29
BARROW, AK
ZIP 99723
Phone: (907) 852-4611
Fax: (907) 852-2163



Authorized Official

Authorized Official NameMR. CATHY WOLFE
Authorized Official TitleDIRECTOR OF NURSING
Authorized Official Phone(907) 852-4611

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 1578758744 is:

CLIA Number02D0641844
Facility TypeHOSPITAL
Certificate TypeCertificate of Accreditation

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
=========3OTHER (01)AK

Other Providers at the same location


The following 16 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1962626267MR. DAVID VENSKO
Individual
Registered Nurse1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9257
1619198645 ROBIN SHEMANSKI RN
Individual
Registered Nurse1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9303
1588877401 GANDY GUINEVERE BECKER
Individual
Registered Nurse1296 AGVIK STREET
BARROW, AK 99723
(907) 852-4611
1730397159MS. REBECCA ANDREW PA-C
Individual
Physician Assistant1296 AGVIK STREET
BARROW, AK 99723
(907) 852-5886
1538365291MRS. MELISSA BARR PA-C
Individual
Physician Assistant1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9211
1326230756ASNA-SAMUEL SIMMONDS MEMORIAL HOSPITAL
Organization
General Acute Care Hospital (Critical Access)1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9203
1881859577SAMUEL SIMMONDS MEMORIAL HOSPITAL
Organization
General Acute Care Hospital (Rural)1296 AGVIK STREET
BARROW, AK 99723
(907) 852-4611
1003179177ARCTIC SLOPE NATIVE ASSOCIATION
Organization
Clinic/Center (Critical Access Hospital)1296 AGVIK STREET
BARROW, AK 99723
(907) 852-4611
1073841797 KIMBERLY R SELF D.D.S.
Individual
Dentist1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9221
1902147952DR. PALMER TOBIAS WETZEL III PHARMD
Individual
Pharmacist1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9277
1770824716DR. TOLULOPE BALOGUN PHARM.D
Individual
Pharmacist1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9267
1669714119DR. JOSEPH MICHAEL RODRIGUEZ PHARMD
Individual
Pharmacist1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9277
1366888539 KAMA JOY BLASING RDH
Individual
Dental Hygienist1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9221
1609298421 MICHAEL SMALLEY LPN
Individual
Licensed Practical Nurse1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9203
1801899257ARCTIC SLOPE NATIVE ASSOCIATION
Organization
Pharmacy1296 AGVIK STREET
BARROW, AK 99723
(907) 852-9277
1225240310SAMUEL SIMMONDS MEMORIAL HOSPITAL
Organization
General Acute Care Hospital (Rural)1296 AGVIK STREET
BARROW, AK 99723
(907) 852-4611

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.