Provider Demographics
NPI:1669861696
Name:A-S MEDICATION SOLUTIONS LLC
Entity Type:Organization
Organization Name:A-S MEDICATION SOLUTIONS LLC
Other - Org Name:ASM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-753-2800
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68026-0008
Mailing Address - Country:US
Mailing Address - Phone:402-753-2800
Mailing Address - Fax:866-441-1680
Practice Address - Street 1:333 S ASHLAND AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2703
Practice Address - Country:US
Practice Address - Phone:312-738-4160
Practice Address - Fax:312-738-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0189003336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0002XSuppliersPharmacyClinic PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149723OtherPK