Provider Demographics
NPI:1912543125
Name:ASPATORE, LYDIA M (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:M
Last Name:ASPATORE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 S LAKESHORE WEST DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-6830
Mailing Address - Country:US
Mailing Address - Phone:765-918-5282
Mailing Address - Fax:
Practice Address - Street 1:821 INDIANAPOLIS RD
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-1451
Practice Address - Country:US
Practice Address - Phone:765-653-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027700A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist