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General NPI Number Information
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NPI Number | 1962999425
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Entity Type | Organization
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Legal Business Name | ASPEN RX LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 1908 CENTRAL DR STE C
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City | BEDFORD
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State | TX
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Zip | 76021-5822
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Country | US
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Telephone | 817-864-1855
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Fax | 817-864-1869
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Provider Business Mailing Address
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Address Line | 1105 CENTRAL EXPY N STE 2105
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City | ALLEN
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State | TX
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Zip | 75013-6103
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Country | US
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Telephone | 469-424-0811
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Fax | 469-421-0814
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Authorized Official
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Title or Position | MANAGER
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Name | AMORIN JULIO
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Credential |
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Telephone | 469-656-7987
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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