Healthcare Provider Details
I. General information
NPI: 1508408329
Provider Name (Legal Business Name): ALEXANDER CHRISTOPHER GRAY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10500 MONTGOMERY RD
CINCINNATI OH
45242
US
IV. Provider business mailing address
5391 SPRUCE MEADOWS CT
MILFORD OH
45150
US
V. Phone/Fax
- Phone: 513-865-1111
- Fax:
- Phone: 740-624-4654
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 03232686 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: