Kodiak Island Health Care Foundation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

KODIAK ISLAND HEALTH CARE FOUNDATION

Doing business as

Kodiak Community Health Center Pharmacy

Practice address

1911 E Rezanof Dr
Kodiak, AK 99615-6602

Phone

(907) 481-5000

NPI assigned

Jan 25, 2024

Organization subpart

No

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

Authorized official

Name

Carol Austerman

Title

Ceo

Phone

(907) 481-5000

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kodiak Community Health Center Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1568224491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-481-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-481-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODIAK ISLAND HEALTH CARE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "AUSTERMAN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-481-5000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "217854",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kodiak Community Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kodiak Island Ambulatory Care Clinic Inc.
• Kodiak Island Assisted Living, LLC
• Kodiak Island Assisted Living, LLC
• Kodiak Island Family Dentistry
• Kodiak Island Health Care Foundation (Kodiak Community Health Center)
• Kodiak Island Medical Associates LLC
• Kodiak Island Medical Associates LLC
• Kodiak Life Diagnostic Imaging, Inc
• Kodiak Vision Clinic & Sally's Eyeland, Inc.
• John M Koller, M.D.

• Community/Retail Pharmacy in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Community/Retail Pharmacy in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.