Provider Demographics
NPI:1508184326
Name:ASTRA PHARMACY ,INC
Entity Type:Organization
Organization Name:ASTRA PHARMACY ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL SOL FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-608-1456
Mailing Address - Street 1:237 NW 12TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1078
Mailing Address - Country:US
Mailing Address - Phone:305-608-1456
Mailing Address - Fax:
Practice Address - Street 1:237 NW 12TH AVE STE D
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1078
Practice Address - Country:US
Practice Address - Phone:305-608-1456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN NUMBER