Healthcare Provider Details

I. General information

NPI: 1174295828
Provider Name (Legal Business Name): VINCENT ASARE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 HODGES FERRY RD
PORTSMOUTH VA
23701-1343
US

IV. Provider business mailing address

3204 SEWELLS POINT RD
NORFOLK VA
23513-2235
US

V. Phone/Fax

Practice location:
  • Phone: 757-465-0063
  • Fax:
Mailing address:
  • Phone: 315-244-4297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202219964
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: