Provider Demographics
NPI:1285267989
Name:PRESCRIPTION CENTER LLC
Entity type:Organization
Organization Name:PRESCRIPTION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIF
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:907-488-8555
Mailing Address - Street 1:167 S SANTA CLAUS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-7755
Mailing Address - Country:US
Mailing Address - Phone:907-488-8555
Mailing Address - Fax:
Practice Address - Street 1:1919 LATHROP ST STE 109
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5937
Practice Address - Country:US
Practice Address - Phone:907-452-1514
Practice Address - Fax:907-452-1917
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESCRIPTION CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy