NPI | 1427079474 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY TANNER CEO 907-277-0644 |
Organization Subpart ? | No |
Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
Additional Taxonomies | 333600000X Pharmacy (Licence: AK 427) |
3336C0003X Pharmacy, Community/Retail Pharmacy | |
Enumeration Date | 2006-07-22 |
Last Update Date | 2025-09-11 |