PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1821271271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821271271 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE HEALTH PARK PHARMACY |
| Practice Address |
3841 Piper St Suite U230 Anchorage AK 99508-4624 |
| Mailing Address |
Po Box 196276 Anchorage AK 99519-6276 |
| Practice Telephone | 9072126868 |
| Practice Fax Number | 9072124955 |
| Mailing Telephone | 9072126868 |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2013-01-11 |
| Authorized Official Name | MR. TODD HOFHEINS (VICE PRESIDENT/CFO) |
| Authorized Official Telephone | 4255253939 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | PH5893 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Health Park Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
3841 PIPER ST SUITE U230 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619972478 | Kymberli Raye Brock | Nurse Practitioner | 3841 Piper St, Suite T100, Anchorage, AK 99508-4624 | 2005-06-17 |
| 1043862774 | Matthew Lee Shryock | Nurse Practitioner | 3841 Piper St, Anchorage, AK 99508-4624 | 2019-07-12 |
| 1558759423 | Arron O'callaghan | Physician Assistant | 3841 Piper St, Suite T-100, Anchorage, AK 99508-4624 | 2014-12-31 |
| 1316341142 | Kimberly S Dahm | Physician Assistant | 3841 Piper St, Suite T377, Anchorage, AK 99508-4624 | 2014-10-22 |
| 1598167033 | Gilbert Lewis Trout IIi | Physician Assistant | 3841 Piper St, Suite T-100, Anchorage, AK 99508-4624 | 2014-09-16 |
| 1003245788 | Bryan Farthing | Physician Assistant | 3841 Piper St, Suite T4-054, Anchorage, AK 99508-4624 | 2013-11-04 |
| 1861745283 | April J Dunlevy | Nurse Practitioner | 3841 Piper St, Suite T-100, Anchorage, AK 99508-4624 | 2012-10-23 |
| 1891047320 | Julia S Mccord | Nurse Practitioner | 3841 Piper St, Suite T300, Anchorage, AK 99508-4624 | 2012-10-08 |
| 1013285618 | Even R Evanson | Physician Assistant | 3841 Piper St, Suite T-100, Anchorage, AK 99508-4624 | 2011-12-09 |
| 1225310634 | Heidi Nichole Felton | Physician Assistant | 3841 Piper St, Suite T300, Anchorage, AK 99508-4624 | 2011-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487118402 | Ledjha Ekstedt | Pharmacy | 4101 Arctic Blvd Ste B, Anchorage, AK 99503-5702 | 2019-01-23 |
| 1750708657 | Genoa Healthcare, LLC | Pharmacy | 4020 Folker St Ste 5, Anchorage, AK 99508-5321 | 2014-03-28 |
| 1356599708 | Target Corporation and Subsidiaries | Pharmacy | 1200 N Muldoon Rd Ste F, Anchorage, AK 99504-6103 | 2008-08-28 |
| 1669401600 | Carr-gottstein Foods Co | Pharmacy | 1340 Gambell St, Anchorage, AK 99501-4630 | 2006-07-02 |
| 1437194206 | Great Land Infusion Pharmacy Inc | Pharmacy | 2421 E Tudor Rd, Ste 107, Anchorage, AK 99507-1128 | 2006-06-17 |
| 1437762879 | Jade Onkle | Pharmacy | 2550 E 88th Ave, Anchorage, AK 99507-3814 | 2020-08-25 |
| 1316952013 | Anchorage Neighborhood Health | Pharmacy | 4951 Business Park Blvd, Anchorage, AK 99503-7174 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295145233 | Ak Pharmacy Management LLC | Pharmacy | 1867 Airport Way Ste 105, Fairbanks, AK 99701-4054 | 2014-04-29 |
| 1346679875 | Three Bears Alaska, Inc | Pharmacy | 3950 S Knik Goose Bay Rd, Wasilla, AK 99623-5008 | 2013-11-05 |
| 1285965772 | Walmart Inc. | Pharmacy | 10096 Kenai Spur Hwy, Kenai, AK 99611-7807 | 2010-01-22 |
| 1447408893 | Target Corporation and Subsidiaries | Pharmacy | 1801 E Parks Hwy, Wasilla, AK 99654-7350 | 2008-08-28 |
| 1053522482 | Juneau Drug At Miners Cove | Pharmacy | 700 S. Franklin St., Juneau, AK 99801 | 2007-05-25 |
| 1215080502 | Downtown Drugstore | Pharmacy | 300 Front St, Ketchikan, AK 99901-6418 | 2007-01-19 |
| 1881776664 | Island Pharmacy Inc | Pharmacy | 3526 Tongass Ave, Ketchikan, AK 99901-5635 | 2006-10-20 |
| 1679655096 | Village Pharmacy of Valdez | Pharmacy | Pioneer and Meals Sts., Valdez, AK 99686 | 2006-10-19 |
| 1871694000 | Foodland Super Drug | Pharmacy | 631 W Willoughby Ave, Juneau, AK 99801-1731 | 2006-09-26 |
| 1467564443 | Inlet Pharmacy Group Inc. | Pharmacy | 299 N Binkley, Soldotna, AK 99669 | 2006-08-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.