Healthcare Provider Details

I. General information

NPI: 1912827585
Provider Name (Legal Business Name): ASHLEY DRAG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

IV. Provider business mailing address

5222 W 109TH ST
OAK LAWN IL
60453-6339
US

V. Phone/Fax

Practice location:
  • Phone: 708-603-5162
  • Fax:
Mailing address:
  • Phone: 708-603-5162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70758
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: