Provider Demographics
NPI:1871864397
Name:ASTIS LONG TERM CARE PHARMACY LLC
Entity Type:Organization
Organization Name:ASTIS LONG TERM CARE PHARMACY LLC
Other - Org Name:ASTI'S LONG TERM CARE PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-997-0408
Mailing Address - Street 1:250 MOUNT LEBANON BLVD
Mailing Address - Street 2:SUITE A1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1252
Mailing Address - Country:US
Mailing Address - Phone:412-561-1499
Mailing Address - Fax:412-561-1998
Practice Address - Street 1:250 MOUNT LEBANON BLVD
Practice Address - Street 2:SUITE A1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1252
Practice Address - Country:US
Practice Address - Phone:412-561-1499
Practice Address - Fax:412-561-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4822023336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133437OtherPK