Provider Demographics
NPI:1477067247
Name:ASTON, BRIAN CLARK (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:CLARK
Last Name:ASTON
Suffix:
Gender:M
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 1:818 THE OLD STATION CT
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8760
Mailing Address - Country:US
Mailing Address - Phone:443-280-1217
Mailing Address - Fax:
Practice Address - Street 1:7270 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5268
Practice Address - Country:US
Practice Address - Phone:410-796-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist