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Organization
KETCHIKAN INDIAN CORPORATION
Active
Organization
KETCHIKAN INDIAN CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY ROSS (RCM)
(907) 228-9254
Entity
Organization
Contact information
Practice address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 225-0320
(907) 247-4819
Mailing address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 225-0320
(907) 247-4819
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202325
NCPDP NUMBER
—
05
—
PH2696
—
AK
Enumeration date
05/18/2007
Last updated
03/07/2023
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