Integrated Support Command Kodiak

NPI #1720064884 in Kodiak, Alaska

Provider Information

NPI Number
1720064884
Entity Type
Organization
Organization Name
Integrated Support Command Kodiak
Subpart
Yes (part of a larger organization)
Parent Organization
US COAST GUARD
Primary Specialty
Clinic/Center
Enumeration Date
Dec 21, 2005
Last Updated
Jul 28, 2008

Practice Location

Address
BUILDING N46 CAPE SARICHEF
City
Kodiak
State
Alaska
ZIP Code
99619-5002
Phone
(907) 487-5757

Authorized Official

Name
TODD LANE EMERSON, CLINIC ADMINISTRATOR
Title
CLINIC ADMINISTRATOR
Phone
(907) 487-5757

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental
Military Clinical Medical Laboratory
Military/U.S. Coast Guard Pharmacy
Clinic/Center

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