Provider Demographics
NPI:1215394440
Name:ALEXANDRIA DRUGS
Entity Type:Organization
Organization Name:ALEXANDRIA DRUGS
Other - Org Name:EASTERN'S PHARMACY LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELRAZZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-304-9956
Mailing Address - Street 1:515 MINOR AVE
Mailing Address - Street 2:STE# 120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2120
Mailing Address - Country:US
Mailing Address - Phone:206-622-2430
Mailing Address - Fax:206-622-3667
Practice Address - Street 1:515 MINOR AVE STE 120B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2138
Practice Address - Country:US
Practice Address - Phone:206-622-2430
Practice Address - Fax:206-622-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2156186OtherPK