PROVIDENCE KODIAK MEDICAL CENTER


Address: 1915 E Rezanof Dr, Kodiak, AK 99615-6602
Phone: 9074863281

PROVIDENCE KODIAK MEDICAL CENTER (NPI# 1306147434) 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) 1306147434
Entity Type Organization
Organization Name PROVIDENCE KODIAK MEDICAL CENTER
Practice Address 1915 E Rezanof Dr
Kodiak
AK 99615-6602
Practice Telephone 9074863281
Practice Fax Number 9074812497
Mailing Telephone 9074863281
Mailing Fax Number 9074812497
Enumeration Date 2010-11-05
Last Update Date 2010-11-05
Authorized Official Name MS. ESTHER L HOXER (RN MANAGER)
Authorized Official Telephone 9074812490
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
31478 AK Nursing & Custodial Care Facilities

Office Location

Street Address 1915 E REZANOF DR
City KODIAK
State AK
Zip Code 99615-6602

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013905660 Providence Health & Services Washington General Acute Care Hospital 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2005-10-07
1093228348 Stephanie Louise Hurley Pharmacist 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2017-11-08
1083125355 Kodiak Life Diagnostic Imaging, Inc Clinic/Center 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2017-10-13
1639555840 Aurora Crye Pharmacist 1915 E Rezanof Dr, Kodiak, AK 99615 2015-08-11
1144666918 John Arthur Mcentee Pharmacist 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2013-05-20
1508150384 Diana Bash Registered Nurse 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2011-06-08
1235421132 Monique Patricia Reckner Registered Nurse 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2011-05-10
1295032910 Kodiak Board Certified Radiology, LLC Radiology 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2011-02-15
1194032631 Amy Jean Deer Registered Nurse 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2010-09-03
1437463601 Louisa Gayle Solesbee Registered Nurse 1915 E Rezanof Dr, Kodiak, AK 99615-6602 2010-07-30
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144864232 Linda Irene Dunlap Spec/Tech, Pathology 1915 E. Remanof Drive, Kodiak, AK 99615 2019-10-31
1639638190 Stephanie Brenteson Community Health Worker 125 Airport Way, Akhiok, AK 99615 2019-03-14
1609351022 Desiree Alexis Wheeler Optometrist 3450 E Rezanof Dr, Kodiak, AK 99615 2018-10-02
1417479072 Elaine Loomis Olsen Case Manager/Care Coordinator 1111 Purtov St., Kodiak, AK 99615 2017-07-14
1750828414 Mary Jean Francisco Case Manager/Care Coordinator 717 East Rezanof Drive, Kodiak, AK 99615 2017-01-19
1558818112 Carolyn Hawes Case Manager/Care Coordinator 717 Rezanof Dr, Kodiak, AK 99615 2016-09-01
1285083683 Amanda Wilson Community Health Worker 124 Akhiok Street, Akhiok, AK 99615 2016-06-07
1447612056 Kailee Champion Massage Therapist 3449 Rezanof Drive East, Kodiak, AK 99615 2016-03-23
1376891069 Krystyna Mcrobert Technician, Other Cape Sarichef Road Bldg N46, Rockmore King Clinic, Kodiak, AK 99615 2012-08-28
1164778619 Mark Anthony Johnson Pharmacist 3449 Rezanof Drive, Kodiak, AK 99615 2012-08-01
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Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407476161 Alaska Olive Care II, LLC Custodial Care Facility 708 N Bunn St, Anchorage, AK 99508-1695 2020-04-23
1952883266 Quality & Quantity Care Services LLC Custodial Care Facility 848 Elaine Dr, Anchorage, Ak, 99504, The Same, Anchorage, AK 99504 2018-09-04
1649524182 Anchorage Adult Day Services Custodial Care Facility 360 Boniface Parkway, Suite B8, Anchorage, AK 99504 2012-11-06
1245591940 Kiwi Assisted Living Home IIi Custodial Care Facility 2948 Princeton Way, Anchorage, AK 99508-4479 2012-05-30
1932482619 Elaine's Place Custodial Care Facility 1025 H St, Anchorage, AK 99501-3430 2011-09-20
1144509365 Abuelita Alh, LLC Custodial Care Facility 1105 San Antonio St, Anchorage, AK 99508-2764 2011-08-04
1114150513 Gloria's Golden Heart Assisted Living, LLC Custodial Care Facility 3713 Robin St, Anchorage, AK 99504-4674 2009-09-01
1003090176 Comfort Assisted Living Homes Custodial Care Facility 7370 Winchester St, Anchorage, AK 99507-2856 2007-12-24
1548461445 Graceful Living LLC Custodial Care Facility 6300 E 9th Ave, Anchorage, AK 99504-1720 2007-05-29
1104957760 Comfort Assisted Living Home Custodial Care Facility 7390 Winchester St, Anchorage, AK 99507-2856 2007-03-08
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Competitor

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City KODIAK
Zip Code 99615

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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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