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General NPI Number Information
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NPI Number | 1396187381
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Entity Type | Individual
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Provider Name | ALEXANDER D MARTIN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 113 1ST ST NE
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City | MOUNT VERNON
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State | IA
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Zip | 52314-1422
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Country | US
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Telephone | 319-895-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 3051 6TH ST SW #12
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City | CEDAR RAPIDS
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State | IA
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Zip | 52404-4085
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Country | US
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Telephone | 920-917-4616
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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 | 22024
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License Number State | IA
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