Providence Kodiak Island Medical Center Retail

LBN: Providence Health & Services Washington
Providence Kodiak Island Medical Center Retail is an health care organization with primary practice located at 1915 E Rezanof Dr , Kodiak AK 99615-6602. The organization recently has 2 registered licenses in different health care specialties including Hospitals / Critical Access, Suppliers / Long Term Care Pharmacy. Hospitals / Critical Access is the primary health care specialty. Providence Health & Services Washington can be contacted via phone (907) 486-9550, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
1915 E Rezanof Dr Kodiak AK 99615-6602
Phone: (907) 486-9550
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Critical Access 282NC0060X 285 Alaska
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1629054374
LBN Legal business name Providence Health & Services Washington
DBA Doing business as Providence Kodiak Island Medical Center Retail
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Dec 15th, 2005
Last updated Dec 10th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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