| NPI | 1760739601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON VP Finance 907-729-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: AK 20467) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2014-08-21 |