Alexsander Tewelde Peacock, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

019734 Issued in LA

Practice address

7515 Perkins Rd
Baton Rouge, LA 70808-4381

Phone

(225) 769-6084

NPI assigned

Mar 12, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Alexsander Tewelde Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Albertsons LLC

  • Community/Retail Pharmacy
  • Baton Rouge, LA
  • NPI 1962449413
  NPD (past)
• Albertsons LLC

  • Community/Retail Pharmacy
  • Ardmore, OK
  • NPI 1134958457
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683331200000",
    "number": "1851784946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28145 WALKER RD S",
            "city": "WALKER",
            "state": "LA",
            "postal_code": "707856027",
            "telephone_number": "225-791-5640",
            "fax_number": "225-791-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084381",
            "telephone_number": "225-769-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "ALEXSANDER",
        "middle_name": "TEWELDE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-12",
        "last_updated": "2023-05-06",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "019734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXSANDER",
            "last_name": "TEWELDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PCP Urgent Care Holdings LLC
• PCP Urgent Care Holdings LLC
• Kyla Pea
• Linda Marie Peace-Buie, NCC, LPC
• Peace, Love, and Faith Pca Service, LLC
• Peak Behavioral Health
• Peak Performance Physical Therapy
• Peak Performance Physical Therapy and Fitness LLC
• Peak Performance Physical Therapy and Fitness, LLC
• Peak Performance Physical Therapy Limited Partnership

• All providers in Baton Rouge, LA
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.