1669861696 NPI number — A-S MEDICATION SOLUTIONS LLC

Table of content: (NPI 1669861696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669861696 NPI number — A-S MEDICATION SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A-S MEDICATION SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669861696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68026-0008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-753-2800
Provider Business Mailing Address Fax Number:
866-441-1680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 S ASHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60607-2703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-738-4160
Provider Business Practice Location Address Fax Number:
312-738-6198
Provider Enumeration Date:
01/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BARTA
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MEMBER
Authorized Official Telephone Number:
402-753-2800

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  054-018900 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2149723 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com