Healthcare Provider Details

I. General information

NPI: 1841800422
Provider Name (Legal Business Name): ALICIA M LEE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N HIGLEY BLVD
RAWLINS WY
82301-5968
US

IV. Provider business mailing address

PO BOX 978
RAWLINS WY
82301-0978
US

V. Phone/Fax

Practice location:
  • Phone: 307-324-3084
  • Fax:
Mailing address:
  • Phone: 307-320-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number4248
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: