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General NPI Number Information
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NPI Number | 1194437640
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Entity Type | Individual
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Provider Name | ALEXANDRA LATALA PHARMD, R.PH.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 2674 FEDERATED BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235-4990
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Country | US
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Telephone | 380-500-4107
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Fax |
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Provider Business Mailing Address
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Address Line | 2674 FEDERATED BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235-4990
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03442612
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License Number State | OH
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