Provider Demographics
NPI:1114685336
Name:ALRAIS, MINA
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:ALRAIS
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 1:201 W ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7357
Mailing Address - Country:US
Mailing Address - Phone:603-264-9246
Mailing Address - Fax:
Practice Address - Street 1:1285 HOOKSETT RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1843
Practice Address - Country:US
Practice Address - Phone:603-668-4705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY01267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist