Provider Demographics
NPI:1174024137
Name:ASHBAUGH, IAN K (RPH)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:K
Last Name:ASHBAUGH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16371-1161
Mailing Address - Country:US
Mailing Address - Phone:814-563-3400
Mailing Address - Fax:
Practice Address - Street 1:114 E MAIN ST
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16371-1161
Practice Address - Country:US
Practice Address - Phone:814-563-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040037L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist