| NPI | 1013905660 |
|---|---|
| Doing Business As | PROVIDENCE KODIAK ISLAND MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Dir Reimb Admin & Asst Sec Enrollmt 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282NC0060X General Acute Care Hospital, Critical Access (Licence: AK 309115) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2019-02-15 |