MEDICARE: ANNE KARNIK JOHNSON R.PH.

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	183500000X	Pharmacist	1461	AK
2	183500000X	Pharmacist	15040	IA
3	183500000X	Pharmacist	008416	KY

General Provider Information

NPI Number	:	1780958918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE KARNIK JOHNSON R.PH.

Provider Business Mailing Address
First Line	:	3755 AIRPORT WAY
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99709-4610
Country	:	US
Telephone Number	:	907-474-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	3755 AIRPORT WAY
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99709-4610
Country	:	US
Telephone Number	:	907-474-1433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/06/2012

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