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SUSITNA PROFESSIONAL PHARMACY

Mail Order Pharmacy

Wasilla, Alaska

Provider NPI: 1467441808

Organization Information:
Organization Name:  SUSITNA PROFESSIONAL PHARMACY


Practice Location:
1751 E GARDNER WAY STE G WASILLA, AK 99654 US
Tel: 907-373-7933  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336M0002XSuppliers
Pharmacy
Mail Order Pharmacy
N3336S0011XSuppliers
Pharmacy
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
AK408

Other Provider Identifiers:

IssuerNumberStateType
PH0266AK05
NCPDP PROVIDER IDENTIFICATION NUMBER020255301
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




PHARMACY JOBS AK - Page 1



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