Provider Demographics
NPI:1891225769
Name:ASHA ONE PHARMACY LLC
Entity Type:Organization
Organization Name:ASHA ONE PHARMACY LLC
Other - Org Name:SHREWSBURY AVENUE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:YEVGENY
Authorized Official - Middle Name:
Authorized Official - Last Name:DETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-530-2880
Mailing Address - Street 1:224 SHREWSBURY AVENUE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-530-2880
Mailing Address - Fax:732-530-2882
Practice Address - Street 1:224 SHREWSBURY AVENUE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-530-2880
Practice Address - Fax:732-530-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy