Lake Otis Pharmacy

LBN: Lake Otis Pharmacy Inc
Lake Otis Pharmacy is an health care organization with primary practice located at 4201 Lake Otis Pkwy , Anchorage AK 99508-5214. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Lake Otis Pharmacy Inc can be contacted via phone (907) 563-7878, or through Sutterlin, Wesley via phone (907) 563-7878.

Contact Information

Primary practice address
4201 Lake Otis Pkwy Anchorage AK 99508-5214
Phone: (907) 563-7878
Fax: (907) 563-7879
Website:
Map and Directions
Authorized official contact:
Name: Sutterlin, Wesley RPH
Phone: (907) 563-7878

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 163 Alaska
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1982625943
LBN Legal business name Lake Otis Pharmacy Inc
DBA Doing business as Lake Otis Pharmacy
Authorized official Sutterlin, Wesley RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2006
Last updated Mar 9th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982625943 NPPES
Alaska MEDICAID PH0163
Alaska Other 0201525

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