Organization Active NPI

Carr-Gottstein Foods Co

Doing business as Carrs Pharmacy #1807

  • Community/Retail Pharmacy
  • Eagle River, AK
National Provider Identifier
1922037969
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CARR-GOTTSTEIN FOODS CO
Doing business as
Carrs Pharmacy #1807
Practice address
11431 Business Blvd
Eagle River, AK 99577-7722
Phone
(907) 696-9460
Fax
(907) 696-9419
NPI assigned
Jul 2, 2006
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Kathy Giannakopoulos
Title
Enrollments Mangaer
Phone
(208) 395-3954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 318 AK
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

11431 Business Blvd
Eagle River, AK 99577-7722

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 1

IdentifierTypeStateIssuer
0200763OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CARRS PHARMACY #1807 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040820000379 TX Part B Supplier - Centralized Flu Biller 2860466489 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID
O20100930065687 AK DME Supplier - PharmacyDME Supplier - Grocery Store 2860466489 Practice locations: Eagle River, AK

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11431 Business Blvd
Eagle River, AK 99577
Phone (907) 696-8783

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1922037969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11431 BUSINESS BLVD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777722",
            "telephone_number": "907-696-9460",
            "fax_number": "907-696-9419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARR-GOTTSTEIN FOODS CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANGAER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AK",
            "license": "318",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0200763",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARRS PHARMACY #1807",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CARRS PHARMACY #1807",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.