Lake Otis Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

163 Issued in AK

Legal business name

LAKE OTIS PHARMACY INC

Doing business as

Lake Otis Pharmacy

Practice address

4201 Lake Otis Pkwy
Anchorage, AK 99508-5214

Phone

(907) 563-7878

Fax

(907) 563-7879

NPI assigned

Jul 22, 2006

Last updated

Mar 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wesley Sutterlin, RPH

Title

President

Phone

(907) 563-7878

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• LAKE OTIS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1982625943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE OTIS PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085214",
            "telephone_number": "907-563-7878",
            "fax_number": "907-563-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE OTIS PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085214",
            "telephone_number": "907-563-7878",
            "fax_number": "907-563-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OTIS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "SUTTERLIN",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-563-7878",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AK",
            "license": "163",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH0163",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0201525",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE OTIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laima Assisted Living Home
• Derrick Lain
• Abby Marissa Laing, N.D.
• Hannah C Laird, MSW
• Marilou M Laisnez, LMFT
• Lake View Home I, II, & III (Lakeview Home Assisted Living)
• Nancy Lake
• Sharon Ann Lake, LPC
• Brittany Lakisa
• Alberta Barbara Laktonen, MD

• Community/Retail Pharmacy in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Community/Retail Pharmacy in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.