Provider Demographics
NPI:1972712487
Name:ALEXANDER, PAULA S (RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:S
Other - Last Name:MARTILLARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2255 S ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2522
Mailing Address - Country:US
Mailing Address - Phone:303-761-1977
Mailing Address - Fax:303-467-5355
Practice Address - Street 1:3292 PEORIA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1517
Practice Address - Country:US
Practice Address - Phone:303-343-6642
Practice Address - Fax:303-343-6932
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPHA.0015241OtherCOLORADO STATE LICENSE