Organization
KODIAK ISLAND HEALTH CARE FOUNDATION
Active
Organization
KODIAK ISLAND HEALTH CARE FOUNDATION
Active
Other names
Kodiak Community Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL AUSTERMAN (CEO)
(907) 481-5000
Entity
Organization
Contact information
Practice address
1911 E REZANOF DR, KODIAK, AK 99615-6602
(907) 481-5000
Mailing address
1911 E REZANOF DR, KODIAK, AK 99615-6602
(907) 481-5000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217854
STATE LICENSE
AK
Enumeration date
01/25/2024
Last updated
01/25/2024
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