NPIMap

Organization Active NPI

HSWL Fo Kodiak Det Ketchikan

  • Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
  • Ketchikan, AK
National Provider Identifier
1285948877
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military and U.S. Coast Guard Ambulatory Procedure Clinic/CenterTaxonomy code 261QM1101X
Legal business name
HSWL FO KODIAK DET KETCHIKAN
Practice address
1300 Stedman St
Ketchikan, AK 99901-6661
Phone
(907) 228-0320
Fax
(907) 228-0255
NPI assigned
Aug 6, 2010
Organization subpart
Yes
Parent organization
U.S. COAST GUARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Robert Bidwell
Title
Clinic Administrator
Phone
(907) 228-0320

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101X Primary
Military/U.S. Coast Guard Pharmacy 332000000X

Addresses

Primary practice location

1300 Stedman St
Ketchikan, AK 99901-6661

Mailing address

1300 Stedman St
Ketchikan, AK 99901-6661
Phone (907) 228-0320

Other names 1

  • Integrated Support Command Ketchikan Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
HSWL Fo Kodiak Det Ketchikan2 organizations share this tax ID, including this one
Part of
HSWL Fo Kodiak Det Ketchikan

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1285948877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 STEDMAN ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016661",
            "telephone_number": "907-228-0320",
            "fax_number": "907-228-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 STEDMAN ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016661",
            "telephone_number": "907-228-0320",
            "fax_number": "907-228-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSWL FO KODIAK DET KETCHIKAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. COAST GUARD",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "BIDWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "907-228-0320"
    },
    "taxonomies": [
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Support Command Ketchikan",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.