Provider Demographics
NPI:1134254568
Name:NEPTUNE, ANDRE GERARD (RPH)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:GERARD
Last Name:NEPTUNE
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 1:205 E DIMOND BLVD # 132
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1909
Mailing Address - Country:US
Mailing Address - Phone:907-346-8271
Mailing Address - Fax:
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:PROVIDENCE ALASKA MEDICAL CENTER-INPATIENT PHARMACY
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4615
Practice Address - Country:US
Practice Address - Phone:907-261-2546
Practice Address - Fax:907-261-3645
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist