Provider Demographics
NPI:1912210758
Name:ALEXANDER PHARMACY LLP
Entity Type:Organization
Organization Name:ALEXANDER PHARMACY LLP
Other - Org Name:ALEXANDER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES / MANAGING MBR
Authorized Official - Prefix:
Authorized Official - First Name:MONGTRINH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-623-0962
Mailing Address - Street 1:6540 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3142
Mailing Address - Country:US
Mailing Address - Phone:727-623-0962
Mailing Address - Fax:727-329-8711
Practice Address - Street 1:6540 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3142
Practice Address - Country:US
Practice Address - Phone:727-623-0962
Practice Address - Fax:727-329-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH247613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002422300Medicaid
FL002422301Medicaid
2125926OtherPK
2125926OtherPK