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General NPI Number Information
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NPI Number | 1902378300
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Entity Type | Individual
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Provider Name | KEVIN JOHN ASH RPH
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Gender | Male
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Dates
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Enumeration Date | 12/23/2018
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Last Update Date | 12/23/2018
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Provider Practice Location Address
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Address Line | 1013 STATE HIGHWAY 29A
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-5828
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Country | US
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Telephone | 518-725-8661
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Fax |
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Provider Business Mailing Address
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Address Line | 541 PARK AVE
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City | ALBANY
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State | NY
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Zip | 12208-3207
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Country | US
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Telephone | 518-791-7560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 064282
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License Number State | NY
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