MANIILAQ ASSOCIATION (NPI# 1740484989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740484989 |
| Entity Type | Organization |
| Organization Name | MANIILAQ ASSOCIATION |
| Other Organization Name | MANIILAQ HEALTH CENTER |
| Practice Address |
436 5th & Ted Stevens Way Kotzebue AK 99752 |
| Mailing Address |
Po Box 43 Kotzebue AK 99752-0043 |
| Practice Telephone | 9074423321 |
| Practice Fax Number | 9074427250 |
| Mailing Telephone | 9074423321 |
| Mailing Fax Number | 9074427250 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAUL HANSON (ADMINISTRATOR) |
| Authorized Official Telephone | 9704423321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
234051 | AK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | PH4146 | 05 |
| Other Name | Type Code |
|---|---|
| Maniilaq Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376810937 | Maniilaq Association | Clinic/Center | 80 Back St., Shungnak, AK 99773-0080 | 2011-11-28 |
| 1700153442 | Maniilaq Association | Clinic/Center | 8 Bering St., Kivalina, AK 99750-0008 | 2011-11-23 |
| 1265709901 | Maniilaq Association | Clinic/Center | 51003 Main St., Kobuk, AK 99751-0003 | 2011-11-23 |
| 1639446347 | Maniilaq Association | Clinic/Center | 9 Hillside Rd., Buckland, AK 99727-0009 | 2011-11-23 |
| 1639446362 | Maniilaq Association | Clinic/Center | 90 Aaksaik Rd., Noatak, AK 99761-0090 | 2011-11-23 |
| 1285901918 | Maniilaq Association | Clinic/Center | 1729 Qalgi Ave., Pt. Hope, AK 99766-0049 | 2011-11-23 |
| 1720355456 | Maniilaq Association | Clinic/Center | 1897 Tundra Way, Noorvik, AK 99763-0189 | 2011-11-23 |
| 1255608998 | Maniilaq Association | Clinic/Center | 130 Casanoff Way, Kiana, AK 99749-0130 | 2011-11-23 |
| 1821365552 | Maniilaq Association | Clinic/Center | #3 Adams Landing-old, Selawik, AK 99770 | 2011-11-23 |
| 1518240084 | Maniilaq Association | Skilled Nursing Facility | 436 Mission St, Kotzebue, AK 99752-0510 | 2011-09-21 |
| Street Address |
436 5TH & TED STEVENS WAY |
| City | KOTZEBUE |
| State | AK |
| Zip Code | 99752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992789002 | Robert Perchik | Emergency Medicine | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2005-12-01 |
| 1154706703 | Amy June Carter | Community Health Worker | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2015-07-24 |
| 1306221239 | Vivian Belle Shellabarger | Community Health Worker | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2015-07-21 |
| 1386028876 | Natasha Cannon | Community Health Worker | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2015-07-14 |
| 1487058152 | Elsie Mary Dexter | Community Health Worker | 436 5th & Ted Stevens Way, Maniilaq Health Center, Kotzebue, AK 99752-0043 | 2014-10-09 |
| 1841629375 | John Daniel Parr | Emergency Medicine | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2013-11-05 |
| 1932476413 | June T Ballot | Community Health Worker | 436 5th & Ted Stevens Way, Box 43, Kotzebue, AK 99752-0043 | 2011-11-28 |
| 1750667994 | Sheila Ann Gregg | Community Health Worker | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2011-11-02 |
| 1689956484 | Hans Justin Hansen | Physical Therapist | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2011-09-16 |
| 1760666051 | Erick Torres Semprit | Family Medicine | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2007-12-21 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 99752 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350633 | Tanana Chiefs Confenerce | Pharmacy | Mile 124.4 Glenn Highway, Tok, Ak, AK 99780 | 2020-09-14 |
| 1487699914 | Fred Meyer Stores Inc | Pharmacy | 930 Old Steese Hwy, Fairbanks, AK 99701-3167 | 2006-06-18 |
| 1124627922 | Southcentral Foundation | Pharmacy | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-10-22 |
| 1467051292 | North Pole Prescription Laboratory Inc | Pharmacy | 167 S Santa Claus Ln, North Pole, AK 99705-7755 | 2020-10-22 |
| 1740896265 | Prescription Center Pharmacy LLC | Pharmacy | 1919 Lathrop St Ste 109, Fairbanks, AK 99701-5937 | 2020-09-21 |
| 1811501679 | Professional Pharmacy LLC | Pharmacy | 1001 Noble St, Fairbanks, AK 99701-4948 | 2020-08-31 |
| 1356538748 | Providence Seward Medical Center Drug Room | Pharmacy | 417 First Ave, Seward, AK 99664-0365 | 2007-09-28 |
| 1467661553 | Anchorage Primary Care Clinic | Pharmacy | 4320 Diplomacy Dr, Attn Sherry Reedy, Anchorage, AK 99508-5925 | 2007-05-22 |
| 1467534537 | Cross Road Health Ministries, Inc. | Pharmacy | Mile 187 Glenn Hwy, Glennallen, AK 99588 | 2006-10-19 |
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| 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.