Provider Demographics
NPI:1205587813
Name:ASHU, EMERENCIA
Entity type:Individual
Prefix:
First Name:EMERENCIA
Middle Name:
Last Name:ASHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15147 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3155
Mailing Address - Country:US
Mailing Address - Phone:505-718-2224
Mailing Address - Fax:
Practice Address - Street 1:15147 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3155
Practice Address - Country:US
Practice Address - Phone:505-718-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029573A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist