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NPI Code Detail

MEDICARE: MRS. KRISTA K. HARRIS RPH

MEDICARE: MRS. KRISTA K. HARRIS RPH
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
1183500000XPharmacist00654AK

General Provider Information

NPI Number : 1801127501
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTA K. HARRIS RPH
Provider Business Mailing Address
First Line : PO BOX 61037
Second Line :
City : FAIRBANKS
State : AK
Zip : 99706-1037
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3755 AIRPORT WAY
Second Line : PHARMACY
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 : 01/19/2010
Last Update Date : 01/19/2010

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