KODIAK AREA NATIVE ASSOCIATION PHARMACY
NPI 1003973041
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Kodiak, AK

Q: What is the provider's specialty?

The provider's specialty is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

Active since January 02, 2007CLIA 02D0641002 · Waiver

3449 E REZANOF DR, KODIAK, AK 99615(907) 486-9860(907) 486-9895 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 25, 2023, Jun 5, 2023, Jun 2, 2023 and 1 more (4 updates tracked since 2023).

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About Kodiak Area Native Association Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KODIAK AREA NATIVE ASSOCIATION PHARMACY (NPI 1003973041) is a healthcare organization registered as an indian health service/tribal/urban indian health (i/t/u) pharmacy in Kodiak, Alaska and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 1, 2026 and lists Michael Pfeffer, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003973041

Entity TypeOrganization

Primary Taxonomy332800000X

Legal Business NameKODIAK AREA NATIVE ASSOCIATION PHARMACY

Location Address3449 E REZANOF DRKodiak, AK 99615-6952

Mailing Address3449 E Rezanof DrKodiak, AK 99615-6952 · (907) 486-9860 · Fax (907) 486-9895

Phone(907) 486-9860

Fax(907) 486-9895

Organization SubpartNo

Authorized OfficialMichael PfefferCeo · (907) 486-9801

Enumeration DateJanuary 2, 2007

Last NPPES UpdateJuly 25, 20234 updates tracked since enumeration

NPPES CertifiedJune 5, 2023

✔ NPI 1003973041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers

Taxonomy Code332800000X

License✔ Licensed in AK · 107

Definition

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.

3449 E REZANOF DR, Kodiak, AK 99615

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Other Identifiers 3

Medicaid1028490AK

Other107AK · State Pharmacy License #

Other0201347Ncpdp Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 02D0641002

Kodiak Area Native Association Kana Main · Kodiak, AK

Active · expires Nov 1, 2026

CLIA Number02D0641002

Laboratory TypeCommunity Clinic

Certificate Effective DateNovember 2, 2024

Certificate Expiration DateNovember 1, 2026

Laboratory DirectorAshley Frost

Laboratory Phone(907) 486-9847

Laboratory LocationKodiak Area Native Association Kana Main3449 E Rezanof Drive, Kodiak, AK 99615

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 02D0640982

Kodiak Area Native Association Mill Bay Health Center · Kodiak, AK

Active · expires Mar 29, 2027

CLIA Number02D0640982

Laboratory TypeCommunity Clinic

Certificate Effective DateMarch 30, 2025

Certificate Expiration DateMarch 29, 2027

Laboratory DirectorAshley S. Frost

Laboratory Phone(907) 486-7300

Laboratory LocationKodiak Area Native Association Mill Bay Health Center2414 Mill Bay Road, Kodiak, AK 99615

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES W PHILLIPS DD

Dentist (General Practice)