Healthcare Provider Details

I. General information

NPI: 1689352502
Provider Name (Legal Business Name): ALEXANDER ANDERSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 N 30TH ST STE W103
BILLINGS MT
59101-0127
US

IV. Provider business mailing address

1233 N 30TH ST STE W103
BILLINGS MT
59101-0127
US

V. Phone/Fax

Practice location:
  • Phone: 406-237-3333
  • Fax:
Mailing address:
  • Phone: 406-237-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPHA-PHA-LIC-74266
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: