Individual
MAXWELL ILNICKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559-3362
(907) 543-6000
Mailing address
PO BOX 3362, BETHEL, AK 99559-3362
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
070688
NY
183500000X
Pharmacist
Primary
249619
AK
183500000X
Pharmacist
28RI04319800
NJ
Other
Enumeration date
09/11/2023
Last updated
05/14/2026
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