Provider Demographics
NPI:1396938049
Name:SCHIFF, GLENN F (RPH)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:F
Last Name:SCHIFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2088
Mailing Address - Street 2:201 THIRD AVE, STE 201
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2088
Mailing Address - Country:US
Mailing Address - Phone:907-224-3490
Mailing Address - Fax:907-224-5870
Practice Address - Street 1:201 THIRD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-2088
Practice Address - Country:US
Practice Address - Phone:907-224-3490
Practice Address - Fax:907-224-5870
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCL3490Medicaid