NPI 1225764871 · live from the CMS NPI Registry
Matthew Francis Deraedt, PharmD
Pharmacist in Anchorage, AK. National Provider Identifier 1225764871, active.
NPI record
| NPI | 1225764871 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacist 183500000X |
| Practice location | 4315 Diplomacy Dr, Anchorage, AK 99508 |
| Practice phone | 907-729-2125 |
| Mailing address | 5640 E 98th Ave, Anchorage, AK 99507 |
| Enumerated | July 26, 2022 |
| Last updated | July 26, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist primary | 183500000X | 051300460 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.