Provider Demographics
NPI:1164123170
Name:PERKINS, ALEXA RYANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:RYANN
Last Name:PERKINS
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 1:710 EAST JAY ROAD
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:ME
Mailing Address - Zip Code:04239
Mailing Address - Country:US
Mailing Address - Phone:207-620-4866
Mailing Address - Fax:
Practice Address - Street 1:317 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5803
Practice Address - Country:US
Practice Address - Phone:207-778-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR71067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist