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Organization

MANIILAQ HEALTH CENTER PHARMACY

Active
Other names
MANIILAQ HEALTH CENTER PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
FREDDY KANIKI PHRMD (PHRM CHIEF)
(907) 442-7336
Entity
Organization

Contact information

Practice address
5TH ST AND GRIZZLEY, KOTZEBUE, AK 99752
(907) 442-7182
(907) 442-7309
Mailing address
PO BOX 43, KOTZEBUE, AK 99752-0043

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
1996986
PK
05
HS190P
AK
Enumeration date
11/14/2006
Last updated
10/13/2016
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