Provider Demographics
NPI:1063785764
Name:ALEXANDER, ROBERT S (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2804
Mailing Address - Country:US
Mailing Address - Phone:417-334-3235
Mailing Address - Fax:
Practice Address - Street 1:601 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2804
Practice Address - Country:US
Practice Address - Phone:417-334-3235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO026776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist