Provider Demographics
NPI:1083999635
Name:AMERICAN SPECIALTY PHARMACY, INC
Entity Type:Organization
Organization Name:AMERICAN SPECIALTY PHARMACY, INC
Other - Org Name:ASPCARES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEED
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-218-1641
Mailing Address - Street 1:13988 DIPLOMAT DR
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-8807
Mailing Address - Country:US
Mailing Address - Phone:214-919-2520
Mailing Address - Fax:888-389-7986
Practice Address - Street 1:365 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4810
Practice Address - Country:US
Practice Address - Phone:973-535-0900
Practice Address - Fax:973-535-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007155003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132372OtherPK
3198226OtherNCPDP PROVIDER IDENTIFICATION NUMBER