Provider Demographics
NPI:1669755583
Name:HILTS HORECZKO, ALEXANDRA ELENI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:ELENI
Last Name:HILTS HORECZKO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:ELENI
Other - Last Name:HILTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:975 SERENO DRIVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589
Mailing Address - Country:US
Mailing Address - Phone:707-651-2008
Mailing Address - Fax:707-651-2075
Practice Address - Street 1:975 SERENO DR.
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589
Practice Address - Country:US
Practice Address - Phone:707-651-2008
Practice Address - Fax:707-651-2075
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist