NPIMap

Organization Active NPI

Bernie'S Pharmacy Inc

  • Community/Retail Pharmacy
  • Anchorage, AK
National Provider Identifier
1790781912
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
370 Issued in AK
Legal business name
BERNIE'S PHARMACY INC
Practice address
4100 Lake Otis Parkway, Suite 200
Anchorage, AK 99508
Phone
(907) 562-2138
Fax
(907) 561-0752
NPI assigned
Jun 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
Mrs. Teresa E Hall
Title
Ceo
Phone
(907) 562-2138

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 370 AK Primary

Addresses

Primary practice location

4100 Lake Otis Parkway, Suite 200
Anchorage, AK 99508

Mailing address

4100 Lake Otis Parkway, Suite 200
Anchorage, AK 99508
Phone (907) 562-2138

Other identifiers 3

IdentifierTypeStateIssuer
1021888MedicaidAK
1996604OtherPK
1028489MedicaidAK

Other names 1

  • BERNIE'S PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930099005 AK DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 5890902811 Practice locations: Anchorage, AK
O20120222000606 AK Part B Supplier - Mass Immunization (Roster Biller Only) 5890902811 Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory
Tax ID family
Bernies Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1790781912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PARKWAY, SUITE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-562-2138",
            "fax_number": "907-561-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PARKWAY, SUITE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-562-2138",
            "fax_number": "907-561-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNIE'S PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-562-2138",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AK",
            "license": "370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021888",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1996604",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028489",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERNIE'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BERNIE'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.