Healthcare Provider Details

I. General information

NPI: 1669755583
Provider Name (Legal Business Name): ALEXANDRA ELENI HILTS HORECZKO PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA ELENI HILTS PHARM D

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR.
VALLEJO CA
94589
US

IV. Provider business mailing address

975 SERENO DRIVE
VALLEJO CA
94589
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-2008
  • Fax: 707-651-2075
Mailing address:
  • Phone: 707-651-2008
  • Fax: 707-651-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: