National Provider Identifier Database

INTEGRATED SUPPORT COMMAND KODIAK
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).


Contact Information

INTEGRATED SUPPORT COMMAND KODIAK
BUILDING N46 CAPE SARICHEF
KODIAK, AK99619-5002
Phone: 907-487-5757
Fax: 907-487-5360
Website:
Specialty Taxonomy Code
* Clinic/Center 261Q00000X
Dental 261QD0000X
Military Clinical Medical Laboratory 291900000X
Military/U.S. Coast Guard Pharmacy 332000000X

* Indicates primary specialty

NPI Profile & details for INTEGRATED SUPPORT COMMAND KODIAK

NPI Number 1720064884
Legal business name
LBN
INTEGRATED SUPPORT COMMAND KODIAK
Authorized official TODD EMERSON - (CLINIC ADMINISTRATOR)
Entity Organization
Organization subpart Yes
Enumeration date 12/21/2005
Last updated 07/28/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • AK License #: 02D0666660
  • AK License #: NCPDP0202414

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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