Provider Demographics
NPI:1164129334
Name:ALEX MARIE RD LLC
Entity Type:Organization
Organization Name:ALEX MARIE RD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:480-351-0210
Mailing Address - Street 1:280 S EVERGREEN RD UNIT 1357
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-5163
Mailing Address - Country:US
Mailing Address - Phone:480-276-5984
Mailing Address - Fax:
Practice Address - Street 1:2500 S POWER RD STE 222
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6690
Practice Address - Country:US
Practice Address - Phone:480-351-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty