Provider Demographics
NPI:1164161618
Name:VISAN, ALEXANDER CHRISTOPHER (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:CHRISTOPHER
Last Name:VISAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 S MARYLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-5888
Mailing Address - Country:US
Mailing Address - Phone:702-683-7153
Mailing Address - Fax:
Practice Address - Street 1:4001 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7556
Practice Address - Country:US
Practice Address - Phone:702-732-1840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV22756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist