OrganizationActive
Bountiful
NPI 1114736899 · Meals Provider · Ketchikan, AK
Provider details
- NPI number
- 1114736899
- Entity type
- Organization
- Primary specialty
- Meals ProviderOther Service Providers
- Authorized official
- Kevin Hall, Owner
Practice location
25 Jefferson Way Ste 102
Ketchikan, AK 99901-5953
Phone: (201) 259-0289
Fax: (973) 215-2052
Mailing address
25 Jefferson Way Ste 102
Ketchikan, AK 99901-5953
Registry dates
- Enumerated
- 2025-01-06
- Last updated
- 2025-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.