Provider Demographics
NPI:1629375159
Name:AMERICAN SPECIALTY PHARMACY INC
Entity Type:Organization
Organization Name:AMERICAN SPECIALTY PHARMACY INC
Other - Org Name:AMERICAN SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-218-1641
Mailing Address - Street 1:8787 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5446
Mailing Address - Country:US
Mailing Address - Phone:214-432-0300
Mailing Address - Fax:
Practice Address - Street 1:8787 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5446
Practice Address - Country:US
Practice Address - Phone:214-432-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273223336C0003X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5902588OtherNCPDP PROVIDER IDENTIFICATION NUMBER