Hswl Fo Kodiak Det Ketchikan

NPI #1285948877 in Ketchikan, Alaska

Provider Information

NPI Number: 1285948877
Entity Type: Organization
Organization Name: Hswl Fo Kodiak Det Ketchikan
Subpart: Yes (part of a larger organization)
Parent Organization: U.S. COAST GUARD
Primary Specialty: Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure
Enumeration Date: Aug 6, 2010
Last Updated: Aug 6, 2010

Practice Location

Address: 1300 STEDMAN ST
City: Ketchikan
State: Alaska
ZIP Code: 99901-6661
Phone: (907) 228-0320

Authorized Official

Name: ROBERT BIDWELL
Title: CLINIC ADMINISTRATOR
Phone: (907) 228-0320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military/U.S. Coast Guard Pharmacy	332000000X
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure	261QM1101X	Primary

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