Provider Demographics
NPI:1437763158
Name:INFUSE ALASKA LLC
Entity Type:Organization
Organization Name:INFUSE ALASKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:907-953-9625
Mailing Address - Street 1:175 N BINKLEY ST UNIT 2980
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-1180
Mailing Address - Country:US
Mailing Address - Phone:907-222-9979
Mailing Address - Fax:888-728-0205
Practice Address - Street 1:6250 TUTTLE PL STE 7
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2094
Practice Address - Country:US
Practice Address - Phone:907-953-9823
Practice Address - Fax:888-728-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy