Healthcare Provider Details

I. General information

NPI: 1437064771
Provider Name (Legal Business Name): ALEXIS FLETCHER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W DEYOUNG ST
MARION IL
62959-5884
US

IV. Provider business mailing address

122 N MANNERING ST
ROYALTON IL
62983-1111
US

V. Phone/Fax

Practice location:
  • Phone: 618-998-7000
  • Fax:
Mailing address:
  • Phone: 618-927-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051309146
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: