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Organization
CORDOVA COMMUNITY MEDICAL CENTER
Active
Organization
CORDOVA COMMUNITY MEDICAL CENTER
Active
Other names
CORDOVA COMMUNITY MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DENNA STAVIG (DIRECTOR OF FINANCE)
(907) 424-8228
Entity
Organization
Contact information
Practice address
602 CHASE AVE, CORDOVA, AK 99574-0160
(907) 424-8000
(907) 424-8116
Mailing address
PO BOX 160, 602 CHASE AVE, CORDOVA, AK 99574-0160
(907) 424-8000
(907) 424-8116
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
AK
313M00000X
Nursing Facility/Intermediate Care Facility
—
AK
314000000X
Skilled Nursing Facility
—
AK
3416L0300X
Land Ambulance
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200927
NCPDP PHARM #
AK
05
—
CM6143
—
AK
05
—
CM9745
—
AK
05
—
CMG287
—
AK
05
—
DA4455
—
AK
05
—
HC2871
—
AK
05
—
HS07IP
—
AK
05
—
HS07LT
—
AK
05
—
HS07OP
—
AK
05
—
HS07SB
—
AK
05
—
MH6324
—
AK
Enumeration date
09/20/2006
Last updated
10/04/2022
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