# INTEGRATED SUPPORT COMMAND KODIAK

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** US COAST GUARD
- **Other names:** Rockmore-King Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720064884
- **Legal business name:** US COAST GUARD
- **Authorized official:** TODD LANE EMERSON CLINIC ADMINISTRATOR (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (907) 487-5757

## Contact information

- **Practice address:** BUILDING N46 CAPE SARICHEF, KODIAK, AK 99619-5002
- **Practice address phone:** (907) 487-5757
- **Practice address fax:** (907) 487-5360
- **Mailing address:** BUILDING N 46 CAPE SARLCHEF, KODIAK, AK 99619-5002
- **Mailing address phone:** (907) 487-5757
- **Mailing address fax:** (907) 487-5360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | AK | Yes |
| 261QD0000X | Dental Clinic/Center | — | AK | — |
| 291900000X | Military Clinical Medical Laboratory | 02D0666660 | AK | — |
| 332000000X | Military/U.S. Coast Guard Pharmacy | NCPDP0202414 | AK | — |

## Other

- **Enumeration date:** 12/21/2005
- **Last updated:** 07/28/2008