Provider Demographics
NPI:1225380470
Name:MCMANUS, DOUGLAS (RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 A ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4008
Mailing Address - Country:US
Mailing Address - Phone:907-563-6600
Mailing Address - Fax:
Practice Address - Street 1:3101 A ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4008
Practice Address - Country:US
Practice Address - Phone:907-563-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051286140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist