Kic Tribal Health Clinic
LBN: Ketchikan Indian Corporation
Kic Tribal Health Clinic is an health care organization with primary practice located at 2960 Tongass Ave Business Office, Ketchikan AK 99901-5742. The organization recently has 4 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Ketchikan Indian Corporation can be contacted via phone (907) 228-9200, or through Ross, Wendy via phone (907) 228-9254.
Contact Information
Primary practice address
2960 Tongass Ave Business Office
Ketchikan AK 99901-5742
Phone: (907) 228-9200
Fax: (800) 887-8796
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 78545 | Alaska |
| Agencies / Community/Behavioral Health | 251S00000X | 78545 | Alaska |
| Ambulatory Health Care Facilities / Dental | 261QD0000X | 78545 | Alaska |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | 78545 | Alaska |
Profile Details
| NPI number | 1821120486 |
|---|---|
| LBN Legal business name | Ketchikan Indian Corporation |
| DBA Doing business as | Kic Tribal Health Clinic |
| Authorized official | Ross, Wendy |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 9th, 2007 |
| Last updated | Apr 28th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821120486 | NPPES |
| Alaska | MEDICAID | CL2696 |
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