Organization
KETCHIKAN INDIAN CORPORATION
Active
Other names
KIC Tribal Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY ROSS (RCM)
(907) 228-9254
Entity
Organization
Contact information
Practice address
2960 TONGASS AVE, BUSINESS OFFICE, KETCHIKAN, AK 99901-5742
(907) 228-9200
(800) 887-8796
Mailing address
2960 TONGASS AVE, BUSINESS OFFICE, KETCHIKAN, AK 99901-5742
(907) 228-9200
(800) 887-8796
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
78545
AK
251S00000X
Community/Behavioral Health Agency
78545
AK
261QD0000X
Dental Clinic/Center
78545
AK
261QP2300X
Primary Care Clinic/Center
Primary
78545
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL2696
—
AK
Enumeration date
03/09/2007
Last updated
04/28/2021
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