Provider Demographics
NPI:1497419386
Name:ASH PHARMACY LLC
Entity Type:Organization
Organization Name:ASH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:SAMPSON
Authorized Official - Middle Name:
Authorized Official - Last Name:TONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:508-980-7111
Mailing Address - Street 1:1067 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2406
Mailing Address - Country:US
Mailing Address - Phone:508-864-7021
Mailing Address - Fax:508-796-5770
Practice Address - Street 1:1067 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2406
Practice Address - Country:US
Practice Address - Phone:508-864-7021
Practice Address - Fax:508-796-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy