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NPI Code Detail

MEDICARE: DEREK J STOLEN

MEDICARE: DEREK J STOLEN
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
1183500000XPharmacist1215AK

General Provider Information

NPI Number : 1346591203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK J STOLEN
Provider Business Mailing Address
First Line : 8900 OLD SEWARD HWY
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-2022
Country : US
Telephone Number : 907-344-7300
Fax Number : 907-344-7305
Provider Business Practice Location Address
First Line : 8900 OLD SEWARD HWY
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-2022
Country : US
Telephone Number : 907-344-7300
Fax Number : 907-344-7305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2012
Last Update Date : 10/01/2012

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Directions to “ DEREK J STOLEN ” Practice Location

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