MANIILAQ HEALTH CENTER PHARMACY


Address: 5th St and Grizzley, Kotzebue, AK 99752
Phone: 9074427182

MANIILAQ HEALTH CENTER PHARMACY (NPI# 1154493666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154493666
Entity Type Organization
Organization Name MANIILAQ HEALTH CENTER PHARMACY
Other Organization Name MANIILAQ HEALTH CENTER PHARMACY
Practice Address 5th St and Grizzley
Kotzebue
AK 99752
Mailing Address Po Box 43
Kotzebue
AK 99752-0043
Practice Telephone 9074427182
Practice Fax Number 9074427309
Enumeration Date 2006-11-14
Last Update Date 2016-10-13
Authorized Official Name FREDDY KANIKI (PHRM CHIEF)
Authorized Official Telephone 9074427336
Authorized Official Credential PHRMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
AK HS190P 05
PK 1996986 01

Other Provider/Organization Names

Other Name Type Code
MANIILAQ HEALTH CENTER PHARMACY Doing Business As Name - Organization

Office Location

Street Address 5TH ST AND GRIZZLEY
City KOTZEBUE
State AK
Zip Code 99752

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770103731 Breanna Rosales Counselor 433 5 Th Ave, Kotzebue, AK 99752 2020-04-20
1679118814 Verna Mariam Sherman Case Manager/Care Coordinator 733 2nd Ave., Kotzebue, AK 99752 2019-11-12
1568979565 John Steven Ferraro Counselor 733 2'nd Ave, Kotzebue, AK 99752 2017-12-29
1528585494 Guardian Flight LLC Ambulance Teacher Housing Apt # 18 Lagoon Street, Kotzebue, AK 99752 2017-08-23
1366998114 Alaskans Changing Together, Inc. Counselor 241 5th Ave, Kotzebue, AK 99752 2016-08-31
1205236692 Kimberly Baldwin Dental Therapist 436 5th Ave Ted Stevens Way, Kotzebue, AK 99752 2014-09-04
1811309040 Sylvia Michelle Windham Advanced Practice Midwife 436 5th Avenue and Ted Stevens Way, Kotzebue, AK 99752 2014-05-22
1881941193 Belynda M. Gregg Case Manager/Care Coordinator 256 2nd Ave, F.r. Ferguson Building, Kotzebue, AK 99752 2012-08-07
1689932436 Srikanth Rao Dakoji Family Medicine 479 Mission St, Apt C8, Kotzebue, AK 99752 2012-04-30
1932434792 Joseph E Copeland Family Medicine Maniilaq Healh Center, Box 43, Kotzebue, AK 99752 2009-10-13
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Taxonomy Information

Taxonomy Code 332800000X
Grouping Suppliers
Classification Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

Taxonomy Definition

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1720460652 Alaska Native Tribal Health Consortium Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 3801 University Lake Dr Ste 100, Anchorage, AK 99508-4658 2015-06-27
1972869071 Alaska Native Tribal Health Consortium Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1w326, 4315 Diplomacy Drive, Anchorage, AK 99508 2012-04-03
1194848242 Searhc Haines Medical Clinic Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 131 First Ave South, Haines, AK 99827-1549 2007-04-06
1366587743 Scf Rasu Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 4160 Tudor Centre Dr, Anchorage, AK 99508-5901 2007-02-21
1881780880 Searhc - Mte Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 222 Tongass Drive, Sitka, AK 99835 2006-10-05
1851486153 Searhc - Juneau Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1200 Salmon Creek Road, Juneau, AK 99801 2006-10-03
1245605179 Norton Sound Health Corporation Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 189 Airport Road, Unalakleet, AK 99684-0189 2015-12-03
1760739601 Southcentral Foundation Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 2012-08-09
1811106271 Alaska Native Tribal Health Consortium Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 4315 Diplomacy Dr, Anchorage, AK 99508-5926 2007-05-22
1699983361 Ketchikan Indian Community Health Clinic Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 2960 Tongass Ave, Ketchikan, AK 99901-5742 2007-05-18
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Competitor

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City KOTZEBUE
Zip Code 99752

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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