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CH107930 KODIAK ISLAND HEALTH CARE FOUNDATION (Active)
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Main Details
Name
KODIAK ISLAND HEALTH CARE FOUNDATION
Subdivision Name
KODIAK COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001401
340B ID
CH107930
Grant Number
H80CS01445
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
2/6/2004
Last Recertification Date
2/20/2025
Contacts
Authorizing Official
Kodiak island health care foundation
Olivera Wilson, Executive Director/CEO
(907) 481-5002
Primary Contact
Kodiak island health care foundation
Raquel McIntyre, Quality Director
(907) 481-5079
Addresses
Street Address
1911 E Rezanof Dr
Kodiak, AK 99615-6602
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/28/08 UPDATED ADDR (1915 E. REZANOF)
01/12/2010
May 2025
May 2025
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