MEDICARE: ANCHORAGE MEDSET PHARMACY INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	412	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1997057	OTHER		PK

General Provider Information

NPI Number	:	1346261476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHORAGE MEDSET PHARMACY INC

Provider Business Mailing Address
First Line	:	4101 ARCTIC BLVD
Second Line	:	STE B
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5702
Country	:	US
Telephone Number	:	907-770-6081
Fax Number	:	907-770-6082

Provider Business Practice Location Address
First Line	:	4101 ARCTIC BLVD
Second Line	:	STE B
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5702
Country	:	US
Telephone Number	:	907-770-6081
Fax Number	:	907-770-6082

Authorized Official
Title or Position	:	OWNER,PIC,AO
Name	:	LARRY FLYNN
Credential	:	RPH
Telephone Number	:	907-770-6081

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	08/31/2015

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