Ilanka Community Health Center | |
705 2nd Street Cordova AK 99574 | |
(907) 424-3622 | |
(907) 424-3681 |
Full Name | Ilanka Community Health Center |
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Speciality | Clinic/Center |
Location | 705 2nd Street, Cordova, Alaska |
Authorized Official Name and Position | Cindy Bradford (OPERATIONS MANAGER) |
Authorized Official Contact | 9074243622 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ilanka Community Health Center Po Box 2290 Cordova AK 99574-2290 Ph: (907) 424-3622 | Ilanka Community Health Center 705 2nd Street Cordova AK 99574 Ph: (907) 424-3622 |
NPI Number | 1821074535 |
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Provider Enumeration Date | 12/15/2005 |
Last Update Date | 09/14/2021 |
Medicare PECOS PAC ID | 1052220878 |
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Medicare Enrollment ID | O20040116000589 |
Identifier | Type | State | Issuer |
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1821074535 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | 703435 (Alaska) | Primary |
Provider Name | Brian James Iutzi |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134534712 PECOS PAC ID: 6406075951 Enrollment ID: I20171011001900 |
Provider Name | Joseph Nyholm |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1528588738 PECOS PAC ID: 2961774237 Enrollment ID: I20200923001877 |
Provider Name | Yaima Alonso-jeckell |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1609141910 PECOS PAC ID: 4587967120 Enrollment ID: I20201002000677 |
Provider Name | Michelle M Denault |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1306289525 PECOS PAC ID: 2466742440 Enrollment ID: I20201130000055 |
Provider Name | Delia Reyes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497355390 PECOS PAC ID: 3779996277 Enrollment ID: I20201230000223 |
Provider Name | Benjamin D Head |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962898080 PECOS PAC ID: 0042515702 Enrollment ID: I20210525000299 |
Provider Name | Barbara Solomon |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1740856103 PECOS PAC ID: 8527465764 Enrollment ID: I20210930001306 |
Provider Name | Lucinda Motley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417198292 PECOS PAC ID: 7719166289 Enrollment ID: I20230220002494 |
Provider Name | Gowri Ramachandran |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1285089284 PECOS PAC ID: 8729322409 Enrollment ID: I20230415000143 |
Provider Name | Laily Md Mahoozi |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1700868940 PECOS PAC ID: 4789604810 Enrollment ID: I20231221000978 |
Provider Name | Susan Ec Powell |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1356776165 PECOS PAC ID: 0244683522 Enrollment ID: I20240202001519 |
Provider Name | Brenda Kay Thayer |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1184128464 PECOS PAC ID: 6507201449 Enrollment ID: I20240229004243 |
Ilanka Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Second St, Cordova, AK 99574 Phone: 907-424-3622 | |
Cordova Community Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 Chase Ave, Cordova, AK 99574 Phone: 907-424-8000 Fax: 907-424-8116 |