Healthcare Provider Details

I. General information

NPI: 1669142113
Provider Name (Legal Business Name): ALEXA M DONOVAN PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUDLEY ST FL 2
PROVIDENCE RI
02905-3233
US

IV. Provider business mailing address

56 NASH LN
ATTLEBORO MA
02703-2543
US

V. Phone/Fax

Practice location:
  • Phone: 401-895-1859
  • Fax: 401-889-5089
Mailing address:
  • Phone: 401-523-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH05953
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: