Provider Demographics
NPI:1720363518
Name:ALEXANDER, MARK DAVID (RPH)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DAVID
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146
Mailing Address - Country:US
Mailing Address - Phone:724-342-3291
Mailing Address - Fax:724-342-5138
Practice Address - Street 1:900 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146
Practice Address - Country:US
Practice Address - Phone:724-342-3291
Practice Address - Fax:724-342-5138
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038086R183500000X
PARPI001500183500000X
OH03216378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist