Provider Demographics
NPI:1740653054
Name:JOHNSON, ASHLEY A (PHARN D)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARN D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 TUNLAW RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1828
Mailing Address - Country:US
Mailing Address - Phone:585-455-0831
Mailing Address - Fax:
Practice Address - Street 1:3075 MARSHALL HALL RD
Practice Address - Street 2:
Practice Address - City:BRYANS ROAD
Practice Address - State:MD
Practice Address - Zip Code:20616-3240
Practice Address - Country:US
Practice Address - Phone:585-455-0831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist