Provider Demographics
NPI:1619067691
Name:ALEXANDER PHARMACY LP
Entity Type:Organization
Organization Name:ALEXANDER PHARMACY LP
Other - Org Name:SAVON DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,PIC,AO
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:979-335-4810
Mailing Address - Street 1:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-1303
Mailing Address - Country:US
Mailing Address - Phone:979-335-4810
Mailing Address - Fax:979-335-4185
Practice Address - Street 1:123 LEVERIDGE
Practice Address - Street 2:
Practice Address - City:EAST BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435
Practice Address - Country:US
Practice Address - Phone:979-335-4810
Practice Address - Fax:979-335-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246863336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145656Medicaid
2095773OtherPK
TX145656Medicaid