Provider Demographics
NPI:1699028464
Name:RIUTTA, ERIK ABRAHAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:ABRAHAM
Last Name:RIUTTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 MILL BAY RD
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-7809
Mailing Address - Country:US
Mailing Address - Phone:907-481-1675
Mailing Address - Fax:907-481-1672
Practice Address - Street 1:2911 MILL BAY RD
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-7809
Practice Address - Country:US
Practice Address - Phone:907-481-1675
Practice Address - Fax:907-481-1672
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist