Organization
CARR-GOTTSTEIN FOODS CO
Active
Other names
CARRS PHARMACY #1807
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANGAER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
11431 BUSINESS BLVD, EAGLE RIVER, AK 99577-7722
(907) 696-9460
(907) 696-9419
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
318
AK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200763
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/02/2006
Last updated
03/04/2020
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