MEDICARE: ANGELA M LEBOEUF RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	1096	AK

General Provider Information

NPI Number	:	1043959729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M LEBOEUF RPH

Provider Business Mailing Address
First Line	:	1200 AIRPORT HEIGHTS DR STE 195
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-2982
Country	:	US
Telephone Number	:	907-279-2425
Fax Number	:	907-279-2426

Provider Business Practice Location Address
First Line	:	1200 AIRPORT HEIGHTS DR STE 195
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-2982
Country	:	US
Telephone Number	:	907-279-2425
Fax Number	:	907-279-2426

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2022
Last Update Date	:	06/01/2022

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