Provider Demographics
NPI:1487324075
Name:BASKIN, ALEXA RAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:RAE
Last Name:BASKIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 CHARLES FARM CIR APT 120
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2661
Mailing Address - Country:US
Mailing Address - Phone:440-915-6923
Mailing Address - Fax:
Practice Address - Street 1:2188 MIDLAND TRL
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-9117
Practice Address - Country:US
Practice Address - Phone:502-633-4209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist