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General NPI Number Information
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NPI Number | 1649477126
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Entity Type | Organization
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Legal Business Name | CHUGACHMIUT
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2035 SEWARD HIGHWAY
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City | SEWARD
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State | AK
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Zip | 99664
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Country | US
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Telephone | 907-224-4907
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Fax | 907-224-3146
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Provider Business Mailing Address
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Address Line | 1840 BRAGAW ST STE 110
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City | ANCHORAGE
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State | AK
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Zip | 99508-3463
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Country | US
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Telephone | 907-224-4907
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Fax | 907-224-3146
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Authorized Official
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Title or Position | HEALTH SERVICES DIVISION DIRECTOR
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Name | KELLEY BAKER
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Credential |
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Telephone | 907-562-4155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number | PHAR411
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License Number State | AK
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