Provider Demographics
NPI:1003134495
Name:ALEXANDER, BETH J (PHARMD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:J
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 PALACE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2952
Mailing Address - Country:US
Mailing Address - Phone:651-699-0290
Mailing Address - Fax:612-330-1757
Practice Address - Street 1:1302 PALACE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2952
Practice Address - Country:US
Practice Address - Phone:651-699-0290
Practice Address - Fax:612-330-1757
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1149371835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy