Healthcare Provider Details

I. General information

NPI: 1255250478
Provider Name (Legal Business Name): ALEXANDRIA RAKESTRAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308-2212
US

IV. Provider business mailing address

8208 BROOKWOOD VALLEY CIR NE # 8208
ATLANTA GA
30309-1458
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-4411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH035630
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: