Healthcare Provider Details

I. General information

NPI: 1619225075
Provider Name (Legal Business Name): ALEXANDRA ZOLOTY PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34099 MELINZ PKWY UNIT G
EASTLAKE OH
44095-4041
US

IV. Provider business mailing address

34099 MELINZ PKWY UNIT G
EASTLAKE OH
44095-4041
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-4239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03132092
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: