Provider Demographics
NPI:1689454605
Name:ASCENDANT PHARMACY INCORPORATED
Entity Type:Organization
Organization Name:ASCENDANT PHARMACY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-775-1827
Mailing Address - Street 1:8125 RONSON RD STE G
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2010
Mailing Address - Country:US
Mailing Address - Phone:858-987-1020
Mailing Address - Fax:858-987-1022
Practice Address - Street 1:8125 RONSON RD STE G
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2010
Practice Address - Country:US
Practice Address - Phone:858-987-1020
Practice Address - Fax:858-987-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy