Organization
GREATER FAIRBANKS COMM
Active
Other names
FAIRBANKS MEMORIAL HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN COTTER RPH (DIR OF PHCY)
(907) 458-5621
Entity
Organization
Contact information
Practice address
1650 COWLES ST, DEPT 41 A, FAIRBANKS, AK 99701-5907
(907) 458-5610
(907) 458-5622
Mailing address
1650 COWLES ST, DEPT 41 A, FAIRBANKS, AK 99701-5907
(907) 458-5610
(907) 458-5622
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PHAR395
AK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997054
PK
—
05
—
PH7525
—
AK
Enumeration date
08/22/2006
Last updated
09/13/2016
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