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General NPI Number Information
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NPI Number | 1275047532
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Entity Type | Organization
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Legal Business Name | AERENSON ROAD PHARMACY, LLC
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Dates
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Enumeration Date | 11/24/2017
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Last Update Date | 01/16/2018
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Provider Practice Location Address
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Address Line | 115 AERENSON DR
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City | MILFORD
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State | DE
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Zip | 19963-1241
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Country | US
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Telephone | 302-430-0995
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Fax | 302-430-0995
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Provider Business Mailing Address
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Address Line | 115 AERENSON DR
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City | MILFORD
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State | DE
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Zip | 19963-1241
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Country | US
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Telephone | 302-430-0995
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Fax | 302-430-0995
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | EDWARD ARASE
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Credential |
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Telephone | 410-251-1885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | A3-0001015
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License Number State | DE
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