Organization
VETERAN AFFIAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY BROOKE BOUCHER (PHARMACY TECH)
(907) 631-6916
Entity
Organization
Contact information
Practice address
7130 W. WELLINGTON DR., WASILLA, AK 99654
(907) 631-6916
Mailing address
P.O. BOX 879511, WASILLA, AK 99687
(907) 631-6916
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
587
AK
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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