Provider Demographics
NPI:1437647138
Name:KING, ALEXANDER WARREN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:WARREN
Last Name:KING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 N HILL FARMS LN
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4812
Mailing Address - Country:US
Mailing Address - Phone:801-721-5286
Mailing Address - Fax:
Practice Address - Street 1:1710 E SKYLINE DR
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-5202
Practice Address - Country:US
Practice Address - Phone:801-479-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6227284-1702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist