=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912210758
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALEXANDER PHARMACY LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2010
-----------------------------------------------------
Last Update Date | 02/20/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6540 PARK BLVD N
-----------------------------------------------------
City | PINELLAS PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33781-3142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-623-0962
-----------------------------------------------------
Fax | 727-329-8711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6540 PARK BLVD N
-----------------------------------------------------
City | PINELLAS PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33781-3142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-623-0962
-----------------------------------------------------
Fax | 727-329-8711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES / MANAGING MBR
-----------------------------------------------------
Name | MONGTRINH HUYNH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-623-0962
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PH24761
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------