Provider Demographics
NPI:1285636985
Name:FORINASH, ALICIA BEVERLY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:BEVERLY
Last Name:FORINASH
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 1:5714 GOETHE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3252
Mailing Address - Country:US
Mailing Address - Phone:314-446-8505
Mailing Address - Fax:314-446-8500
Practice Address - Street 1:1027 BELLEVUE AVE STE 205
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-768-8339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010043071835P1200X
IL051-2889681835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy