Organization · Type 2 NPI

Integrated Support Command Kodiak

Clinic/Center · Kodiak, AK

NPI number 1720064884 Active

Practice location

Building N46 Cape Sarichef
Kodiak, AK 99619-5002

Call (907) 487-5757 Map

Fax (907) 487-5360

Mailing address

Building N 46 Cape Sarlchef
Kodiak, AK 99619-5002

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed
Dental Clinic/Center	261QD0000X	None listed
Military Clinical Medical Laboratory	291900000X	02D0666660 (AK)
Military/U.S. Coast Guard Pharmacy	332000000X	NCPDP0202414 (AK)

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

5 other providers at this address

NPI record

NPI: 1720064884
Entity type: Organization (Type 2)
Issued: Dec 21, 2005
Last updated: Jul 28, 2008
Status: Active
Subpart: Yes of Us Coast Guard

Other names

<unavail>
Rockmore-King Clinic · doing business as

Authorized official

Todd Lane Emerson, CLINIC ADMINISTRATOR
Clinic Administrator
(907) 487-5757

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1720064884

Integrated Support Command Kodiak's National Provider Identifier is 1720064884, issued on Dec 21, 2005. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Kodiak, AK. The record was last updated on Jul 28, 2008.