Provider Demographics
NPI:1578001392
Name:DUBOIS, ALEXANDER J (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:J
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 WOODS MILL RD
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-5101
Mailing Address - Country:US
Mailing Address - Phone:636-594-1104
Mailing Address - Fax:
Practice Address - Street 1:998 WOODS MILL RD
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-5101
Practice Address - Country:US
Practice Address - Phone:636-594-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016032407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist