# UNITED STATES COAST GUARD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033517206
- **Authorized official:** MISS STEPHANIE LUBBERS (CORPSMAN)
- **Authorized official phone:** (907) 487-5757

## Contact information

- **Practice address:** BASE KODIAK BUILDING N-46, KODIAK, AK 99619
- **Practice address phone:** (907) 487-5757
- **Mailing address:** BASE KODIAK BUILDING N-46 CAPE SARICHEF, KODIAK, AK 99619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/19/2014
- **Last updated:** 12/19/2014