Organization
KODIAK AREA NATIVE ASSOCIATION PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PFEFFER CEO (CEO)
(907) 486-9801
Entity
Organization
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9860
(907) 486-9895
Mailing address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9860
(907) 486-9895
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
107
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201347
NCPDP NUMBER
—
05
—
1028490
—
AK
01
—
107
STATE PHARMACY LICENSE #
AK
Enumeration date
01/02/2007
Last updated
07/25/2023
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