Organization
GREAT LAND INFUSION PHARMACY INC
Active
Other names
GREAT LAND INFUSION PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS SCOTT NOAEILL RPH (PRESIDENT/OWNER)
(907) 561-2421
Entity
Organization
Contact information
Practice address
2421 E TUDOR RD, STE 107, ANCHORAGE, AK 99507-1128
(907) 561-2421
(907) 868-5154
Mailing address
PO BOX 230368, GREAT LAND INFUSION PHARMACY, ANCHORAGE, AK 99523
(907) 561-2421
(907) 868-5154
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
429
AK
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997065
PK
—
05
—
MS0429
—
AK
05
—
PH0429
—
AK
Enumeration date
06/17/2006
Last updated
04/27/2021
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