Organization Active NPI

Asthenis, LLC

  • Community/Retail Pharmacy
  • Providence, RI
National Provider Identifier
1124520994
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHA00664 Issued in RI
Legal business name
ASTHENIS, LLC
Practice address
206 Cranston St
Providence, RI 02907
Phone
(401) 473-3958
Fax
(401) 861-1837
NPI assigned
Mar 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eugenio Fernandez
Title
Pharmacist/Owner
Phone
(401) 473-3958

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHA00664 RI Primary

Addresses

Primary practice location

206 Cranston St
Providence, RI 02907

Mailing address

206 Cranston St
Providence, RI 02907-2308
Phone (401) 473-3958

Other identifiers 2

IdentifierTypeStateIssuer
1124520994MedicaidRI
2176311OtherPK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180912000059 RI Part B Supplier - Pharmacy 8921358037 Practice locations: Providence, RI
O20230209001602 RI DME Supplier - Pharmacy 8921358037 Practice locations: Providence, RI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Asthenis LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

206 Cranston St
Providence, RI 02907
Phone (401) 473-3958

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1124520994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CRANSTON ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072308",
            "telephone_number": "401-473-3958",
            "fax_number": "401-861-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CRANSTON ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02907",
            "telephone_number": "401-473-3958",
            "fax_number": "401-861-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTHENIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "EUGENIO",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "401-473-3958"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": "PHA00664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124520994",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.