Provider Demographics
NPI:1619482890
Name:ALFF, KEVIN JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:ALFF
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 1:3221 MANAWA CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-7672
Mailing Address - Country:US
Mailing Address - Phone:712-366-7032
Mailing Address - Fax:712-366-7039
Practice Address - Street 1:3221 MANAWA CENTRE DR
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-7672
Practice Address - Country:US
Practice Address - Phone:712-366-7032
Practice Address - Fax:712-366-7039
Is Sole Proprietor?:No
Enumeration Date:2017-12-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11630183500000X
IA19766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist