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General NPI Number Information
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NPI Number | 1912095654
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Entity Type | Individual
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Provider Name | SUSAN WHEELER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 CHIEF EDDIE HOFFMAN HIGHWAY
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City | BETHEL
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State | AK
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Zip | 99559
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Country | US
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Telephone | 907-543-6652
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 707
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City | BETHEL
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State | AK
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Zip | 99559-0707
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Country | US
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Telephone | 907-543-7603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1641
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4795614-1701
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00064951
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License Number State | WA
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