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Contact Information

SUSITNA MEDISET SERVICES INC
1751 E GARDNER WAY
STE F
WASILLA, AK99654-6564
 Phone: 907-352-4306
 Fax: 907-357-7590
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SUSITNA MEDISET SERVICES INC

NPI # 1548455967
LBN Legal business name SUSITNA MEDISET SERVICES INC
Authorized official MARY MUNDELL - (EXECT VP)
Entity Organization
Organization subpart 1 No
Enumeration date 09/10/2007
Last updated 03/07/2012 - About 14 years ago
Identifiers
AK License # 438
AK Medicaid PH0267
Other 0227810 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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