MEDICARE: ALASKA NATIVE TRIBAL HEALTH CONSORTIUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	3336C0002X	Clinic Pharmacy
3	332800000X	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2157799	OTHER		PK

General Provider Information

NPI Number	:	1679931059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALASKA NATIVE TRIBAL HEALTH CONSORTIUM

Provider Business Mailing Address
First Line	:	4315 DIPLOMACY DR
Second Line	:	OUTPATIENT PHARMACY
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5926
Country	:	US
Telephone Number	:	907-729-2112
Fax Number	:	907-729-2190

Provider Business Practice Location Address
First Line	:	3900 AMBASSADOR DR STE 311
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5922
Country	:	US
Telephone Number	:	907-729-2112
Fax Number	:	907-729-2190

Authorized Official
Title or Position	:	PHARMACY DIRECTOR
Name	:	ASHLEY SCHABER
Credential	:
Telephone Number	:	907-729-2126

Provider Enumeration Date	:	02/01/2016
Last Update Date	:	03/23/2023

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