Providence Kodiak Island Medical Center

LBN: Providence Health & Services Washington
Providence Kodiak Island Medical Center is an health care organization with primary practice located at 1838 Chichenof St , Kodiak AK 99615-6519. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Providence Health & Services Washington can be contacted via phone (907) 486-3281, or through Anderson, Donald W via phone (425) 525-5392.

Contact Information

Primary practice address
1838 Chichenof St Kodiak AK 99615-6519
Phone: (907) 486-3281
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald W
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 309115 Alaska

Profile Details

NPI number 1366658858
LBN Legal business name Providence Health & Services Washington
DBA Doing business as Providence Kodiak Island Medical Center
Authorized official Anderson, Donald W
Entity Organization
Organization subpart 1 No
Enumeration date May 14th, 2007
Last updated Jun 14th, 2024 - about 5 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1366658858 NPPES
Alaska MEDICAID HS10LT

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