Provider Demographics
NPI:1104200856
Name:ASTER DISCOUNT PHARMACY, INC.
Entity Type:Organization
Organization Name:ASTER DISCOUNT PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:772-577-6469
Mailing Address - Street 1:718 SW PORT ST LUCIE BLVD
Mailing Address - Street 2:UNIT # 2
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2689
Mailing Address - Country:US
Mailing Address - Phone:772-577-6469
Mailing Address - Fax:772-577-6657
Practice Address - Street 1:718 SW PORT ST LUCIE BLVD
Practice Address - Street 2:UNIT # 2
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2689
Practice Address - Country:US
Practice Address - Phone:772-577-6469
Practice Address - Fax:772-577-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy