Organization
FOUNDATION HEALTH LLC
Active
Other names
DENALI PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY G SUDDUTH (CFO)
(907) 458-5300
Entity
Organization
Contact information
Practice address
1650 COWLES ST, DEPT 41 C, FAIRBANKS, AK 99701-5907
(907) 458-5615
(907) 458-5060
Mailing address
1650 COWLES ST, FAIRBANKS, AK 99701-5907
(907) 458-5550
(907) 458-5060
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1656561
—
AK
Enumeration date
08/22/2006
Last updated
10/02/2023
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