Provider Demographics
NPI:1689951030
Name:ALSTAT, VALERIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:ALSTAT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2120
Mailing Address - Country:US
Mailing Address - Phone:618-457-8397
Mailing Address - Fax:618-549-3052
Practice Address - Street 1:1600 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2120
Practice Address - Country:US
Practice Address - Phone:618-457-8397
Practice Address - Fax:618-549-3052
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051294451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist