Organization
KODIAK AREA NATIVE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE PFEFFER (CEO)
(907) 486-9800
Entity
Organization
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9800
(907) 486-9897
Mailing address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9800
(907) 486-9897
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
233103
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003903
—
AK
Enumeration date
05/28/2006
Last updated
02/15/2024
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