Organization
CORDOVA COMMUNITY MEDICAL CENTER
Active
Other names
CORDOVA COMMUNITY MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DENNA STAVIG (DIRECTOR OF FINANCE)
(907) 424-8228
Entity
Organization
Contact information
Practice address
602 CHASE AVE, CORDOVA, AK 99574-0160
(907) 424-8000
(907) 424-8116
Mailing address
PO BOX 160, 602 CHASE AVE, CORDOVA, AK 99574-0160
(907) 424-8000
(907) 424-8116
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
AK
313M00000X
Nursing Facility/Intermediate Care Facility
—
AK
314000000X
Skilled Nursing Facility
—
AK
3416L0300X
Land Ambulance
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200927
NCPDP PHARM #
AK
05
—
CM6143
—
AK
05
—
CM9745
—
AK
05
—
CMG287
—
AK
05
—
DA4455
—
AK
05
—
HC2871
—
AK
05
—
HS07IP
—
AK
05
—
HS07LT
—
AK
05
—
HS07OP
—
AK
05
—
HS07SB
—
AK
05
—
MH6324
—
AK
Enumeration date
09/20/2006
Last updated
10/04/2022
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