Provider Demographics
NPI:1811099245
Name:ASHTON PHARMACY
Entity type:Organization
Organization Name:ASHTON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-673-9494
Mailing Address - Street 1:9035 ASHTON RD
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19136
Mailing Address - Country:US
Mailing Address - Phone:215-673-9494
Mailing Address - Fax:215-673-9705
Practice Address - Street 1:9035 ASHTON RD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19136
Practice Address - Country:US
Practice Address - Phone:215-673-9494
Practice Address - Fax:215-673-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410088L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005726600001Medicaid
3906471Medicare UPIN
PA281784Medicare ID - Type Unspecified