Provider Demographics
NPI:1679683718
Name:AMERICAN SERVICE AND PRODUCT INC
Entity Type:Organization
Organization Name:AMERICAN SERVICE AND PRODUCT INC
Other - Org Name:ASAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHARDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-671-1200
Mailing Address - Street 1:16612 107TH CT
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8898
Mailing Address - Country:US
Mailing Address - Phone:708-671-1200
Mailing Address - Fax:708-448-8598
Practice Address - Street 1:16612 107TH CT
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8898
Practice Address - Country:US
Practice Address - Phone:708-671-1200
Practice Address - Fax:708-448-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1474650OtherHUMANA
IL=========01Medicaid
IL=========01Medicaid