Organization
INTEGRATED SUPPORT COMMAND KODIAK
Active
Parent organization
US COAST GUARD
Other names
Rockmore-King Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
US COAST GUARD
Authorized official
TODD LANE EMERSON CLINIC ADMINISTRATOR (CLINIC ADMINISTRATOR)
(907) 487-5757
Entity
Organization
Contact information
Practice address
BUILDING N46 CAPE SARICHEF, KODIAK, AK 99619-5002
(907) 487-5757
(907) 487-5360
Mailing address
BUILDING N 46 CAPE SARLCHEF, KODIAK, AK 99619-5002
(907) 487-5757
(907) 487-5360
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
AK
261QD0000X
Dental Clinic/Center
—
AK
291900000X
Military Clinical Medical Laboratory
02D0666660
AK
332000000X
Military/U.S. Coast Guard Pharmacy
NCPDP0202414
AK
Other
Enumeration date
12/21/2005
Last updated
07/28/2008
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