Provider Demographics
NPI:1164536132
Name:ASB PHARMACIES INC
Entity Type:Organization
Organization Name:ASB PHARMACIES INC
Other - Org Name:RIDGECREST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARONDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BASRAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-366-8287
Mailing Address - Street 1:1844 SAN MIGUEL DR
Mailing Address - Street 2:STE 105
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4962
Mailing Address - Country:US
Mailing Address - Phone:925-937-6800
Mailing Address - Fax:925-937-4149
Practice Address - Street 1:1844 SAN MIGUEL DR
Practice Address - Street 2:STE 105
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4962
Practice Address - Country:US
Practice Address - Phone:925-937-6800
Practice Address - Fax:925-937-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
CAPHY532753336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2151723OtherPK
CAPHA374770Medicaid