| NPI | 1366658858 |
|---|---|
| Doing Business As | PROVIDENCE KODIAK ISLAND MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MIKE BUTLER SVP CFO 425-525-3362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AK 309115) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-01-26 |