Individual provider Active NPI

Beau Robert Craig, PHARMACIST

  • Pharmacist
  • Anchorage, AK
National Provider Identifier
1396231957
Registry record updated Jul 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
131391 Issued in AK
Practice address
5600 Debarr Rd
Anchorage, AK 99504-2300
Phone
(907) 339-0900
NPI assigned
Jul 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 131391 AK Primary

Addresses

Primary practice location

5600 Debarr Rd
Anchorage, AK 99504-2300

Mailing address

10288 Jamestown Dr Unit D
Anchorage, AK 99507-4584
Phone (712) 330-2829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
131391AKMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530921600000",
    "number": "1396231957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10288 JAMESTOWN DR UNIT D",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074584",
            "telephone_number": "712-330-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995042300",
            "telephone_number": "907-339-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "BEAU",
        "middle_name": "ROBERT",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2018-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "131391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.