Provider Demographics
NPI:1972869071
Name:ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
Entity Type:Organization
Organization Name:ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
Other - Org Name:ALASKA NATIVE MEDICAL CENTER MEDISET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-729-2126
Mailing Address - Street 1:PO BOX 94134
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:907-729-2190
Practice Address - Street 1:1W326
Practice Address - Street 2:4315 DIPLOMACY DRIVE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-729-2199
Practice Address - Fax:907-729-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0228165OtherNCPDP PROVIDER IDENTIFICATION NUMBER