=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255097531
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN SPECIALTY PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2021
-----------------------------------------------------
Last Update Date | 11/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 818 E GRAYSON ST STE A
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78208-1013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-598-2678
-----------------------------------------------------
Fax | 210-255-8358
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13988 DIPLOMAT DR STE 100
-----------------------------------------------------
City | FARMERS BRANCH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-8831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-919-2520
-----------------------------------------------------
Fax | 210-255-8358
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | ABDUL HAMEED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-919-2520
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------