Healthcare Provider Details

I. General information

NPI: 1386655421
Provider Name (Legal Business Name): THREE BEARS ALASKA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10575 KENAI SPUR HWY
KENAI AK
99611-7812
US

IV. Provider business mailing address

7362 W PARKS HWY BOX 814
WASILLA AK
99623-9300
US

V. Phone/Fax

Practice location:
  • Phone: 907-335-2061
  • Fax: 907-335-2062
Mailing address:
  • Phone: 907-357-4311
  • Fax: 907-357-4312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR432
License Number StateAK

VIII. Authorized Official

Name: PAUL SONNENBERG
Title or Position: PRES
Credential:
Phone: 907-357-4311