Provider Demographics
NPI:1801441480
Name:ASAM, JORDAN ASHLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ASHLEY
Last Name:ASAM
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 1:503 SHOEMAKER RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2411
Mailing Address - Country:US
Mailing Address - Phone:267-825-5992
Mailing Address - Fax:
Practice Address - Street 1:1 YORKTOWN PLZ
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1400
Practice Address - Country:US
Practice Address - Phone:215-481-9562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist