Provider Demographics
NPI:1922308709
Name:VANDI, ALEX (RPH)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:VANDI
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 1:2009 TREETOP LN APT 44
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7687
Mailing Address - Country:US
Mailing Address - Phone:240-338-6614
Mailing Address - Fax:
Practice Address - Street 1:5800 SILVER HILL RD
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1103
Practice Address - Country:US
Practice Address - Phone:301-568-2233
Practice Address - Fax:301-568-9422
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist