Provider Demographics
NPI:1376143735
Name:ASHBY, KELLI (PHARM D)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:ASHBY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17850 GARLAND GROH BLVD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1944
Mailing Address - Country:US
Mailing Address - Phone:301-714-1377
Mailing Address - Fax:301-766-0718
Practice Address - Street 1:17850 GARLAND GROH BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-1944
Practice Address - Country:US
Practice Address - Phone:301-714-1377
Practice Address - Fax:301-766-0718
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist