Healthcare Provider Details

I. General information

NPI: 1043525470
Provider Name (Legal Business Name): LAUCHLAND ALEXANDER ROBERTS II PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 UNION AVE
MEMPHIS TN
38104-3415
US

IV. Provider business mailing address

41 S 4TH ST APT. 402
MEMPHIS TN
38103-5210
US

V. Phone/Fax

Practice location:
  • Phone: 901-516-8812
  • Fax:
Mailing address:
  • Phone: 970-215-6194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18941
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: