Healthcare Provider Details

I. General information

NPI: 1245900166
Provider Name (Legal Business Name): ALEXANDER THORP SHELDON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEXANDER SHELDON THORP PHARMD

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N GREEN BAY RD
NEENAH WI
54956-1954
US

IV. Provider business mailing address

3930 LONE ELM DR
BROOKFIELD WI
53005-2274
US

V. Phone/Fax

Practice location:
  • Phone: 920-729-6088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20442-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: