Alexandra Puckett, PHARMD
Individual provider Active NPI Pharmacist · Hines, OR
NPI 1558078873 · NPPES record last updated Nov 7, 2022
Key facts
- NPI
- 1558078873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-0019262 (OR)
- Practice address
- 629 N Hwy 20
Hines, OR 97738-9435 - Phone
- (541) 573-1523
- Fax
- (541) 573-1502
- NPI assigned
- Nov 7, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| RPH-0019262 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0019262 | OR | Yes |
Addresses
Primary practice location
629 N Hwy 20
Hines, OR 97738-9435
Mailing address
629 N Hwy 20
Hines, OR 97738-9435
Phone (541) 573-1523
Other providers in Hines, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2022. 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.