Provider Demographics
NPI:1770196297
Name:RAIMER, ALEX DANIEL (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:DANIEL
Last Name:RAIMER
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 1:48 PEQUOT POINT RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-5113
Mailing Address - Country:US
Mailing Address - Phone:413-212-1975
Mailing Address - Fax:
Practice Address - Street 1:501 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4101
Practice Address - Country:US
Practice Address - Phone:413-499-5411
Practice Address - Fax:413-443-8981
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist