Provider Demographics
NPI:1922389840
Name:ASPIRE RX
Entity Type:Organization
Organization Name:ASPIRE RX
Other - Org Name:ASPIRE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUDASAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-852-2528
Mailing Address - Street 1:4307 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5282
Mailing Address - Country:US
Mailing Address - Phone:215-852-2528
Mailing Address - Fax:
Practice Address - Street 1:4307 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5282
Practice Address - Country:US
Practice Address - Phone:215-883-0332
Practice Address - Fax:215-883-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4821723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2131806OtherPK