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SCH020024-17 CENTRAL PENINSULA HOSPITAL (Active)
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Main Details
Name
CENTRAL PENINSULA HOSPITAL
Subdivision Name
CENTRAL PENINSULA MENTAL WELLNESS - Psychiatry and Psychology
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH020024-17
Medicare Provider Number
020024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/10/2025
Last Recertification Date
Contacts
Authorizing Official
Central Peninsula Hospital
Shaun Patrick Keef, Chief Executive Officer
(907) 714-4719
Primary Contact
Central Peninsula Hospital
Amy Beth Kauffman, Pharmacy Director
(907) 714-4795
Addresses
Street Address
291 N FIREWEED ST
SOLDOTNA, AK 99669-7540
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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