Active NPI
Sooyah Milambo
- Pharmacist
- Fairbanks, AK
National Provider Identifier
1396564365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 224939
- Practice address
- 30 College Rd
Fairbanks, AK 99701-1706 - Phone
- (907) 374-4160
- NPI assigned
- Oct 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 224939 | AK | Primary |
Addresses
Primary practice location
30 College Rd
Fairbanks, AK 99701-1706
Mailing address
30 College Rd
Fairbanks, AK 99701-1759
Other practice location 1
301 N Santa Claus Ln
North Pole, AK 99705-6081
Phone (907) 490-2760
Other practice location 2
3627 Airport Way
Fairbanks, AK 99709-4779
Phone (907) 374-4060
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
| License | State | Type | Specialty |
|---|---|---|---|
| 224939 | AK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1396564365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997011759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 COLLEGE RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997011706",
"telephone_number": "907-374-4160"
}
],
"practiceLocations": [
{
"address_1": "301 N Santa Claus Ln",
"address_purpose": "LOCATION",
"city": "North Pole",
"state": "AK",
"postal_code": "997056081",
"country_code": "US",
"telephone_number": "907-490-2760",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3627 Airport Way",
"address_purpose": "LOCATION",
"city": "Fairbanks",
"state": "AK",
"postal_code": "997094779",
"country_code": "US",
"telephone_number": "907-374-4060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILAMBO",
"first_name": "SOOYAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-07",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AK",
"license": "224939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.