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NPI Code Detail

MEDICARE: ALEXANDRA HAZELET

MEDICARE: ALEXANDRA HAZELET
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
1183500000XPharmacist26027904AIN

General Provider Information

NPI Number : 1811513476
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA HAZELET
Provider Business Mailing Address
First Line : 1701 E PAULDING RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46816-1223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 E PAULDING RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46816-1223
Country : US
Telephone Number : 260-456-3429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2020
Last Update Date : 06/19/2020

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Directions to “ ALEXANDRA HAZELET ” Practice Location

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