Healthcare Provider Details

I. General information

NPI: 1194364182
Provider Name (Legal Business Name): ALEXANDRIA HOLLIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CENTENNIAL WAY
SCOTTDALE PA
15683-1741
US

IV. Provider business mailing address

410 ARTHUR AVE
SCOTTDALE PA
15683-1505
US

V. Phone/Fax

Practice location:
  • Phone: 724-887-4727
  • Fax:
Mailing address:
  • Phone: 724-322-4096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP454103
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: