Provider Demographics
NPI:1952189490
Name:LANDIS, ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LANDIS
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 1:3204 SOCIETY PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3269
Mailing Address - Country:US
Mailing Address - Phone:267-644-5903
Mailing Address - Fax:
Practice Address - Street 1:3204 SOCIETY PL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3269
Practice Address - Country:US
Practice Address - Phone:267-644-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist