Local City Search for Medical Equipment Suppliers PROFESSIONAL HOME IV INC
Home Infusion Therapy Pharmacy
Soldotna, Alaska
Provider NPI: 1053341966
Organization Information:Organization Name: PROFESSIONAL HOME IV INC
Practice Location:
182 S BIRCH ST SOLDOTNA, AK 99669 US
Tel: 907-262-8737 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
182 S BIRCH ST SOLDOTNA, AK 99669 US
Tel: 907-262-8737 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 3336L0003X | Suppliers Pharmacy Long Term Care Pharmacy | AK | PHAR490 |
| Y | 3336H0001X | Suppliers Pharmacy | AK | 490 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1619615 | AK | 05 | |
| 1021642 | AK | 05 | |
| MS1723 | AK | 05 | |
| PH0246 | AK | 05 | |
| 1028530 | AK | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
