| NPI | 1548391162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN ALEXANDER WARD Owner 907-278-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: AK AK0074) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-01-23 |