Provider Demographics
NPI:1003517475
Name:O'NEILL, ALEXIS ANN
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANN
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 N ISABEL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3108
Mailing Address - Country:US
Mailing Address - Phone:520-904-8485
Mailing Address - Fax:
Practice Address - Street 1:9100 N SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7299
Practice Address - Country:US
Practice Address - Phone:520-579-8826
Practice Address - Fax:520-579-8935
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist