NPI 1891096517 · live from the CMS NPI Registry
Leonard Bolog, R.Ph.
Pharmacist in Wasilla, AK. National Provider Identifier 1891096517, active.
NPI record
| NPI | 1891096517 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacist 183500000X |
| Practice location | 595 E Parks Hwy # 300, Wasilla, AK 99654 |
| Practice phone | 907-352-1160 |
| Enumerated | November 11, 2010 |
| Last updated | November 11, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist primary | 183500000X | 1705 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.