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NPI Code Detail

MEDICARE: NORMAN MA PHARMD

MEDICARE: NORMAN MA PHARMD
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
1183500000XPharmacist60877008WA
2183500000XPharmacist140545AK

General Provider Information

NPI Number : 1073078721
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORMAN MA PHARMD
Provider Business Mailing Address
First Line : 2350 LUSARDI POINT CIR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-3153
Country : US
Telephone Number : 415-374-0727
Fax Number :
Provider Business Practice Location Address
First Line : 1650 W NORTHERN LIGHTS BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99517-3340
Country : US
Telephone Number : 415-374-0727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2019
Last Update Date : 02/07/2019

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Directions to “ NORMAN MA PHARMD” Practice Location

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