MEDICARE: MEDSET PHARMACY, LLC

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
1	3336L0003X	Long Term Care Pharmacy	498	AK

General Provider Information

NPI Number	:	1619378270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSET PHARMACY, LLC

Provider Business Mailing Address
First Line	:	200 W 34TH AVE
Second Line	:	SUITE #1013
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-3969
Country	:	US
Telephone Number	:	907-770-6081
Fax Number	:	907-770-6082

Provider Business Practice Location Address
First Line	:	4101 ARCTIC BLVD
Second Line	:	SUITE #107
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5702
Country	:	US
Telephone Number	:	907-770-6081
Fax Number	:	907-770-6082

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	MR. LARRY L FLYNN
Credential	:	RPH
Telephone Number	:	907-770-6081

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	09/12/2014

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