Provider Demographics
NPI:1588295380
Name:MACDONALD, ALEXANDRIA (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26220 CROCKER BLVD
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2455
Mailing Address - Country:US
Mailing Address - Phone:586-954-0800
Mailing Address - Fax:586-466-5084
Practice Address - Street 1:26220 CROCKER BLVD
Practice Address - Street 2:
Practice Address - City:HARRISON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48045-2455
Practice Address - Country:US
Practice Address - Phone:586-954-0800
Practice Address - Fax:586-466-5084
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist