Healthcare Provider Details

I. General information

NPI: 1518384940
Provider Name (Legal Business Name): ALEX PHARM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5185 MACARTHUR BLVD NW # 107
WASHINGTON DC
20016-3341
US

IV. Provider business mailing address

5185 MACARTHUR BLVD NW # 107
WASHINGTON DC
20016-3341
US

V. Phone/Fax

Practice location:
  • Phone: 202-362-0004
  • Fax: 202-362-0006
Mailing address:
  • Phone: 202-362-0004
  • Fax: 202-362-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRX0000068
License Number StateDC

VIII. Authorized Official

Name: AMIR MISAK
Title or Position: OWNER & PIC
Credential: RPH
Phone: 202-362-0004