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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