Provider Demographics
NPI:1710585740
Name:STEWART, ALEC (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:STEWART
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 1:573 S GOODLETT ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-7503
Mailing Address - Country:US
Mailing Address - Phone:901-581-9461
Mailing Address - Fax:
Practice Address - Street 1:2431 N GERMANTOWN PKWY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4494
Practice Address - Country:US
Practice Address - Phone:901-214-0002
Practice Address - Fax:901-214-0010
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist