NPIMap

Organization Active NPI

Cordova Community Medical Center

Doing business as Cordova Community Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Cordova, AK
National Provider Identifier
1609395128
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
126180 Issued in AK
Legal business name
CORDOVA COMMUNITY MEDICAL CENTER
Doing business as
Cordova Community Medical Center Pharmacy
Practice address
602 Chase Ave
Cordova, AK 99574
Phone
(907) 424-8017
Fax
(907) 424-8020
NPI assigned
Sep 15, 2017
Last updated
Jun 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Authorized official

Name
Hannah Joann SandersNPI 1093036071
Title
Ceo
Phone
(907) 424-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 126180 AK Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

602 Chase Ave
Cordova, AK 99574

Mailing address

PO Box 160
Cordova, AK 99574-0160
Phone (907) 424-8254

Other identifiers 2

IdentifierTypeStateIssuer
1677242MedicaidAK
2171578OtherPK

Other names 1

  • Cordova Community Medical Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cordova Community Medical Center4 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1609395128",
    "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": "907-424-8254",
            "fax_number": "907-424-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CHASE AVE",
            "city": "CORDOVA",
            "state": "AK",
            "postal_code": "99574",
            "telephone_number": "907-424-8017",
            "fax_number": "907-424-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA COMMUNITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "JOANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-424-8200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AK",
            "license": "126180",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1677242",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordova Community Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cordova Community Medical Center Pharmacy",
            "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 Jun 25, 2021; 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.