KODIAK ISLAND HEALTH CARE FOUNDATION NPI 1326047044

NPI Information

KODIAK ISLAND HEALTH CARE FOUNDATION is a federally qualified health center (fqhc) clinic center in Kodiak, AK. KODIAK ISLAND HEALTH CARE FOUNDATION NPI is 1326047044. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Kodiak Community Health Center.

The provider's business location address is:

1911 E REZANOF DR.
KODIAK, AK
ZIP 99615
Phone: (907) 481-5000
Fax: (907) 481-5030

The provider's authorized official is Judy Christine Rathje .
The authorized official title is Executive Director and has the following contact phone number (907) 481-5005.

The CLIA number assigned to this NPI record is 02D1020558 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2005 and was last updated on 11/29/2012.

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:

Other Identifiers

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