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General NPI Number Information
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NPI Number | 1104200856
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Entity Type | Organization
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Legal Business Name | ASTER DISCOUNT PHARMACY, INC.
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 718 SW PORT ST LUCIE BLVD UNIT # 2
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-2689
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Country | US
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Telephone | 772-577-6469
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Fax | 772-577-6657
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Provider Business Mailing Address
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Address Line | 718 SW PORT ST LUCIE BLVD UNIT # 2
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-2689
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Country | US
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Telephone | 772-577-6469
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Fax | 772-577-6657
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | SONIA SHARMA
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Credential | RPH
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Telephone | 772-577-6469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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