Healthcare Provider Details

I. General information

NPI: 1326045246
Provider Name (Legal Business Name): TERESA D HIGH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PROVIDENCE DR
ANCHORAGE AK
99508-4661
US

IV. Provider business mailing address

8035 E FROSTLINE RD
ANCHORAGE AK
99507-6132
US

V. Phone/Fax

Practice location:
  • Phone: 907-261-2005
  • Fax: 907-261-4895
Mailing address:
  • Phone: 907-345-1223
  • Fax: 907-261-4895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1263
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: