Copper River Native Association
Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Glennallen, AK
NPI 1962900100 · NPPES record last updated Apr 8, 2026
Key facts
- NPI
- 1962900100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
- License
- 123829 (AK)
- Legal business name
- COPPER RIVER NATIVE ASSOCIATION
- Practice address
- Mile 111.5 Richardson Highway
Glennallen, AK 99588 - Phone
- (907) 822-5241
- Fax
- (907) 822-5695
- NPI assigned
- Jan 23, 2018
- Organization subpart
- No
Authorized official
- Name
- Nikki R Vosburg
- Title
- PFS Manager
- Phone
- (907) 822-8486
Corporate family (same tax ID) 7
Practitioners 5
-
Kristy Faith Johns, EMT
-
Shana Mickenham, LPC, CDCS, BHP
-
Molly Kay Vaughan, PT, DPT, PCS
National Provider Directory
- Tax ID family
- Copper River Native Assoc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | 123829 | AK | Yes |
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
Mile 111.5 Richardson Highway
Glennallen, AK 99588
Mailing address
PO Box 383
Glennallen, AK 99588-0383
Phone (907) 822-5241
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1692814 | Medicaid | AK | |
| 2175467 | Other | PK |
Other names
- CRNA Pharmacy
Other providers in Glennallen, AK
- Kareena L Best
- Saovanee Brahma
- Lisa Marie Buchal
- Andrew Peter Cap
- Copper River Emergency Medical Services Council, Inc.
- Tammy Sue Cronk
- Cross Road Health Ministries, Inc.
- Cross Road Health Ministries, Inc.
- Cross Road Health Ministries, Inc.
- Cross Road Health Ministries, Inc.
All providers in Glennallen, AK · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.