Mary K. Fortin, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

PHAC169 Issued in AK

Practice address

1200 Salmon Creek Lane
Juneau, AK 99801

Phone

(907) 463-4031

Fax

(907) 463-6658

NPI assigned

Jan 23, 2021

Last updated

Jan 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1730779745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNEL DR STE 300",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017837",
            "telephone_number": "907-463-4031",
            "fax_number": "907-463-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SALMON CREEK LANE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-463-4031",
            "fax_number": "907-463-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "MARY",
        "middle_name": "K.",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "AK",
            "license": "PHAC169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy Technician in Juneau, AK
• Providers in Juneau, AK by specialty
• Pharmacy Technician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.