Provider Demographics
NPI:1346833720
Name:VENDER, ALEXANDRA ELISE (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:ELISE
Last Name:VENDER
Suffix:
Gender:F
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 1:99 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3006
Mailing Address - Country:US
Mailing Address - Phone:774-487-6298
Mailing Address - Fax:
Practice Address - Street 1:976 ROUTE 28
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-5664
Practice Address - Country:US
Practice Address - Phone:508-398-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist