Provider Demographics
NPI:1619579497
Name:NIEMER, ALEXANDER JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOSEPH
Last Name:NIEMER
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 1:201 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:KY
Mailing Address - Zip Code:41074-1113
Mailing Address - Country:US
Mailing Address - Phone:594-911-7008
Mailing Address - Fax:859-491-7680
Practice Address - Street 1:201 6TH AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:KY
Practice Address - Zip Code:41074-1113
Practice Address - Country:US
Practice Address - Phone:594-911-7008
Practice Address - Fax:859-491-7680
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY019207OtherPHARMACY LICENSE NUMBER