| NPI | 1629054374 |
|---|---|
| Doing Business As | PROVIDENCE KODIAK ISLAND MEDICAL CENTER RETAIL |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Dir Reimbursemt Regulatory Strategy 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282NC0060X General Acute Care Hospital, Critical Access (Licence: AK 285) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2019-12-10 |