PROVIDENCE HEALTH & SERVICES WASHINGTON NPI 1013905660

NPI Information

NPI: 1013905660
Provider Name: PROVIDENCE HEALTH & SERVICES WASHINGTON

Doing Business As: PROVIDENCE KODIAK ISLAND MEDICAL CENTER

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
1915 E REZANOF DR
KODIAK, AK
ZIP 99615
Phone: (907) 486-3281
Get Directions

PROVIDENCE HEALTH & SERVICES WASHINGTON is a critical access general acute care hospital in Kodiak, AK. PROVIDENCE HEALTH & SERVICES WASHINGTON NPI is 1013905660. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Kodiak Island Medical Center.

The provider's business location address is:

1915 E REZANOF DR
KODIAK, AK
ZIP 99615-602
Phone: (907) 486-3281
Fax: (907) 486-9546

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Dir Reimb Admin & Asst Sec Enrollmt and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 10/7/2005 and was last updated on 2/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	309115	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	HS10	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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