Provider Demographics
NPI:1265912729
Name:ALEXANDER, ROBERT ROSS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ROSS
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 AVONLEA PL APT 304
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-7105
Mailing Address - Country:US
Mailing Address - Phone:706-455-9162
Mailing Address - Fax:
Practice Address - Street 1:50 BARRETT PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3344
Practice Address - Country:US
Practice Address - Phone:770-419-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist