Healthcare Provider Details

I. General information

NPI: 1144619768
Provider Name (Legal Business Name): ALEX GIANNAKOPOULOS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S COOLIDGE ST
MOSES LAKE WA
98837-1873
US

IV. Provider business mailing address

605 S COOLIDGE ST
MOSES LAKE WA
98837-1873
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-0674
  • Fax: 509-932-4086
Mailing address:
  • Phone: 509-765-0674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60483365
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number60867068
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: