Provider Demographics
NPI:1033719174
Name:BASSETT, ALEXANDREIA TAYLOR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDREIA
Middle Name:TAYLOR
Last Name:BASSETT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 TRAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-1814
Mailing Address - Country:US
Mailing Address - Phone:229-221-2014
Mailing Address - Fax:
Practice Address - Street 1:641 VETERANS PKWY S
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31788-8843
Practice Address - Country:US
Practice Address - Phone:229-985-6850
Practice Address - Fax:229-985-9421
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist