# VETERAN AFFIAIRS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558706440
- **Authorized official:** EMILY BROOKE BOUCHER (PHARMACY TECH)
- **Authorized official phone:** (907) 631-6916

## Contact information

- **Practice address:** 7130 W. WELLINGTON DR., WASILLA, AK 99654
- **Practice address phone:** (907) 631-6916
- **Mailing address:** P.O. BOX 879511, WASILLA, AK 99687
- **Mailing address phone:** (907) 631-6916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | 587 | AK | Yes |

## Other

- **Enumeration date:** 05/06/2013
- **Last updated:** 05/06/2013