Matthew Alexander, PHARMD
Individual provider Active NPI Pharmacist · Rolla, MO
NPI 1154925345 · NPPES record last updated Nov 28, 2020
Key facts
- NPI
- 1154925345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2014021077 (MO)
- Practice address
- 500 N Bishop Ave
Rolla, MO 65401-2989 - Phone
- (573) 308-4887
- Fax
- (573) 308-8010
- NPI assigned
- Nov 28, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014021077 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri CVS Pharmacy LLC | Past |
Accepting new patients | |
| Missouri CVS Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2014021077 | MO | Yes |
Addresses
Primary practice location
500 N Bishop Ave
Rolla, MO 65401-2989
Mailing address
500 N Bishop Ave
Rolla, MO 65401-2989
Phone (573) 308-4887
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2014021077 | Other | MO | PHARMACIST LICENSE |
Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.