Provider Demographics
NPI:1821462540
Name:ALIBAH, ANTHONY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ALIBAH
Suffix:
Gender:M
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 1:2080 ROCK LAKE LOOP
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6100
Mailing Address - Country:US
Mailing Address - Phone:757-576-2161
Mailing Address - Fax:
Practice Address - Street 1:100 ROSDALE ROAD
Practice Address - Street 2:WALGREENS
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-534-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist