Provider Demographics
NPI:1043766306
Name:ROWE, ALECIA LEE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ALECIA
Middle Name:LEE
Last Name:ROWE
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 1:221 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ENOSBURG FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05450
Mailing Address - Country:US
Mailing Address - Phone:802-933-7756
Mailing Address - Fax:
Practice Address - Street 1:221 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ENOSBURG FALLS
Practice Address - State:VT
Practice Address - Zip Code:05450
Practice Address - Country:US
Practice Address - Phone:802-933-7756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0105776183500000X
NY058895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist