NPIMap

Organization Active NPI

Cordova Community Hospital

  • Long Term Care Pharmacy
  • Cordova, AK
National Provider Identifier
1013077080
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
280775 Issued in AK
Legal business name
CORDOVA COMMUNITY HOSPITAL
Practice address
602 Chase Ave
Cordova, AK 99574-0160
Phone
(907) 424-8000
Fax
(907) 424-8405
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Bryant
Title
Ceo Admin
Phone
(907) 424-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 280775 AK Primary

Addresses

Primary practice location

602 Chase Ave
Cordova, AK 99574-0160

Mailing address

PO Box 160
Cordova, AK 99574-0160
Phone (907) 424-8000

Other identifiers 2

IdentifierTypeStateIssuer
PH002MedicaidAK
1996576OtherPK

Other names 1

  • CORDOVA COMMUNITY MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cordova Community Hospi4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1013077080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "CORDOVA",
            "state": "AK",
            "postal_code": "995740160",
            "telephone_number": "907-424-8000",
            "fax_number": "907-424-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CHASE AVE",
            "city": "CORDOVA",
            "state": "AK",
            "postal_code": "995740160",
            "telephone_number": "907-424-8000",
            "fax_number": "907-424-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO ADMIN",
        "authorized_official_telephone_number": "907-424-8000"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AK",
            "license": "280775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH002",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1996576",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORDOVA COMMUNITY MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordova, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.