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 1915 E Rezanof Dr , Kodiak AK 99615-6602. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Hospitalist, Hospitals / Critical Access. Allopathic & Osteopathic Physicians / Emergency Medical Services is the primary health care specialty. Providence Health & Services Washington can be contacted via phone (907) 486-3281, 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) 486-3281
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X
Hospitals / Critical Access 282NC0060X 309115 Alaska

Profile Details

NPI number 1952430902
LBN Legal business name Providence Health & Services Washington
DBA Doing business as Providence Kodiak Island Medical Center
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Mar 5th, 2007
Last updated Jul 22nd, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952430902 NPPES
Alaska MEDICAID MDG191

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