Provider Demographics
NPI:1891398848
Name:ASMAH, BENJAMIN KOFI (PHARMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KOFI
Last Name:ASMAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 POINCIANA DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-8917
Mailing Address - Country:US
Mailing Address - Phone:410-845-5824
Mailing Address - Fax:
Practice Address - Street 1:3630 S 18TH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-9102
Practice Address - Country:US
Practice Address - Phone:765-474-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027133A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist