Provider Demographics
NPI:1891361523
Name:LAWSON, ALEXANDRIA DANIELLE
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:DANIELLE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2761 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2021
Mailing Address - Country:US
Mailing Address - Phone:803-254-2761
Mailing Address - Fax:
Practice Address - Street 1:2761 LAUREL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2021
Practice Address - Country:US
Practice Address - Phone:803-254-2761
Practice Address - Fax:803-779-2515
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician