MEDICARE: ALEXANDRIA RAE NORTON PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP451547	PA

General Provider Information

NPI Number	:	1609472745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA RAE NORTON PHARM D

Provider Business Mailing Address
First Line	:	101 CHESTER AVE
Second Line	:
City	:	YEADON
State	:	PA
Zip	:	19050-3822
Country	:	US
Telephone Number	:	610-461-2171
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CHESTER AVE
Second Line	:
City	:	YEADON
State	:	PA
Zip	:	19050-3822
Country	:	US
Telephone Number	:	610-461-2171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2020
Last Update Date	:	12/04/2020

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