Provider Demographics
NPI:1356628895
Name:ASTER, JEFFREY AARON (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:AARON
Last Name:ASTER
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 1:504 F AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-1224
Mailing Address - Country:US
Mailing Address - Phone:541-963-8469
Mailing Address - Fax:
Practice Address - Street 1:1120 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-2220
Practice Address - Country:US
Practice Address - Phone:541-524-0416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist