Provider Demographics
NPI:1982167219
Name:PURVIS, ALEXANDER KING (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:KING
Last Name:PURVIS
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 1:101 FOUR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-7418
Mailing Address - Country:US
Mailing Address - Phone:678-371-9104
Mailing Address - Fax:
Practice Address - Street 1:2730 HIGHWAY 155
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-2401
Practice Address - Country:US
Practice Address - Phone:770-288-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist