Organization
COPPER RIVER NATIVE ASSOCIATION
Active
Other names
CRNA Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI R VOSBURG (PFS MANAGER)
(907) 822-8486
Entity
Organization
Contact information
Practice address
MILE 111.5 RICHARDSON HIGHWAY, GLENNALLEN, AK 99588
(907) 822-5241
(907) 822-5695
Mailing address
PO BOX 383, GLENNALLEN, AK 99588-0383
(907) 822-5241
(907) 822-5695
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
123829
AK
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1692814
—
AK
01
—
2175467
PK
—
Enumeration date
01/23/2018
Last updated
04/08/2026
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