Organization
KODIAK ISLAND HEALTH CARE FOUNDATION
Active
Organization
KODIAK ISLAND HEALTH CARE FOUNDATION
Active
Other names
Kodiak Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVERA WILSON (CEO)
(907) 481-5000
Entity
Organization
Contact information
Practice address
1911 E REZANOF DR., KODIAK, AK 99615
(907) 481-5000
(907) 481-5030
Mailing address
1911 E REZANOF DR, KODIAK, AK 99615-6602
(907) 481-5000
(907) 481-5030
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
297211
AK
261QF0400X
Federally Qualified Health Center (FQHC)
297211
AK
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RH462FQ
—
AK
Enumeration date
07/14/2005
Last updated
07/14/2026
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