Individual
CARMELLA RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
30 COLLEGE RD, FAIRBANKS, AK 99701-1706
(907) 374-4160
Mailing address
30 COLLEGE RD, FAIRBANKS, AK 99701-1706
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
137350
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137530
PHARMACIST LICENSE
AK
Enumeration date
02/01/2019
Last updated
02/01/2019
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