Healthcare Provider Details

I. General information

NPI: 1225516495
Provider Name (Legal Business Name): ALEXANDRA GRECO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DEPT OF PHARMACEUTICAL SERVICES
MORGANTOWN WV
26506-1200
US

IV. Provider business mailing address

1 MEDICAL CENTER DRIVE DEPT OF PHARMACEUTICAL SERVICES (PO BOX 8045)
MORGANTOWN WV
26506-8045
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4148
  • Fax: 304-598-4073
Mailing address:
  • Phone: 304-598-4148
  • Fax: 304-598-4073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberRP0010163
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: