Provider Demographics
NPI:1013507821
Name:BROWN, ALEXANDER NICHOLAS (PHARMD, MBA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:NICHOLAS
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 S 19TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-3136
Mailing Address - Country:US
Mailing Address - Phone:402-617-2752
Mailing Address - Fax:
Practice Address - Street 1:888 S SADDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-1959
Practice Address - Country:US
Practice Address - Phone:402-556-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist