Provider Demographics
NPI:1245982537
Name:ROUNTREE, ALEXIS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:ROUNTREE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BRACKISH PL
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3220
Mailing Address - Country:US
Mailing Address - Phone:228-369-1873
Mailing Address - Fax:
Practice Address - Street 1:3800 MARKET ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-3036
Practice Address - Country:US
Practice Address - Phone:288-202-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-100432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist