Provider Demographics
NPI:1952675639
Name:AMERICAN SPECIALTY PHARMACY INC
Entity Type:Organization
Organization Name:AMERICAN SPECIALTY PHARMACY INC
Other - Org Name:ASPCARES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT/AO
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-919-2520
Mailing Address - Street 1:13988 DIPLOMAT DR
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234
Mailing Address - Country:US
Mailing Address - Phone:214-919-2520
Mailing Address - Fax:214-919-2524
Practice Address - Street 1:2436 S INTERSTATE 35 E STE 360
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4900
Practice Address - Country:US
Practice Address - Phone:940-383-1222
Practice Address - Fax:940-383-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
TX279103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133910OtherPK
TX146554Medicaid