Provider Demographics
NPI:1295037505
Name:ASPIRE RX LLC
Entity Type:Organization
Organization Name:ASPIRE RX LLC
Other - Org Name:ASPIRE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JAY ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-727-1969
Mailing Address - Street 1:9883 S 500 W
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-2561
Mailing Address - Country:US
Mailing Address - Phone:877-221-3464
Mailing Address - Fax:877-221-3472
Practice Address - Street 1:949 E 12400 S
Practice Address - Street 2:A6
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8200
Practice Address - Country:US
Practice Address - Phone:877-221-3464
Practice Address - Fax:877-221-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7798699-17033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127074OtherPK