Provider Demographics
NPI:1548263387
Name:ALASKA INFUSION THERAPY, INC.
Entity type:Organization
Organization Name:ALASKA INFUSION THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:907-789-7570
Mailing Address - Street 1:PO BOX 32960
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-2960
Mailing Address - Country:US
Mailing Address - Phone:907-789-7570
Mailing Address - Fax:907-789-7573
Practice Address - Street 1:9109 MENDENHALL MALL RD
Practice Address - Street 2:STE 7A
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7142
Practice Address - Country:US
Practice Address - Phone:907-789-7570
Practice Address - Fax:907-789-7573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPH407333600000X, 332BP3500X, 261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK0202236OtherNABP NUMBER
AKPH0245Medicaid
AKPH0245Medicaid