Provider Demographics
NPI:1184479479
Name:HARRISON, ALEX TIMOTHY (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:TIMOTHY
Last Name:HARRISON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 NICHOLS ST
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1909
Mailing Address - Country:US
Mailing Address - Phone:585-694-8825
Mailing Address - Fax:
Practice Address - Street 1:2841 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1909
Practice Address - Country:US
Practice Address - Phone:585-352-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist