Organization
HSWL FO KODIAK DET KETCHIKAN
Active
Parent organization
U.S. COAST GUARD
Other names
Integrated Support Command Ketchikan
Organization subpart
Yes
Provider details
NPI number
Legal business name
U.S. COAST GUARD
Authorized official
ROBERT BIDWELL (CLINIC ADMINISTRATOR)
(907) 228-0320
Entity
Organization
Contact information
Practice address
1300 STEDMAN ST, KETCHIKAN, AK 99901-6661
(907) 228-0320
(907) 228-0255
Mailing address
1300 STEDMAN ST, KETCHIKAN, AK 99901-6661
(907) 228-0320
(907) 228-0255
Taxonomy
Speciality
Code
Description
License number
State
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
Primary
—
—
332000000X
Military/U.S. Coast Guard Pharmacy
—
—
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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