Provider Demographics
NPI:1477236248
Name:ALEXANDER, SHAZZIA
Entity Type:Individual
Prefix:
First Name:SHAZZIA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FITZPATRICK ST
Mailing Address - Street 2:
Mailing Address - City:ELMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36025-1463
Mailing Address - Country:US
Mailing Address - Phone:334-614-7077
Mailing Address - Fax:
Practice Address - Street 1:2451 COBBS FORD RD
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7763
Practice Address - Country:US
Practice Address - Phone:334-285-0623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist