Provider Demographics
NPI:1114495470
Name:NEDVED, ALEX (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:NEDVED
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6466 FLINT TRL
Mailing Address - Street 2:
Mailing Address - City:OREGONIA
Mailing Address - State:OH
Mailing Address - Zip Code:45054-9485
Mailing Address - Country:US
Mailing Address - Phone:937-728-6268
Mailing Address - Fax:
Practice Address - Street 1:146 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1423
Practice Address - Country:US
Practice Address - Phone:927-256-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03338113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist