MEDICARE: JENNIFER ALSTON RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	042859	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548442288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ALSTON RPH

Provider Business Mailing Address
First Line	:	2426-34 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-6129
Country	:	US
Telephone Number	:	718-653-3047
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 EASTCHESTER RD # 34
Second Line	:	RITE AID
City	:	BRONX
State	:	NY
Zip	:	10469-5947
Country	:	US
Telephone Number	:	718-653-3047
Fax Number	:	718-653-4947

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	04/22/2020

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