Ast Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Rome, GA
NPI 1245053768 · NPPES record last updated Nov 4, 2024
Key facts
- NPI
- 1245053768
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- AST PHARMACY INC
- Practice address
- 1102 N 5TH Ave NE Ste 200
Rome, GA 30165-2623 - Phone
- (706) 314-9735
- NPI assigned
- Nov 4, 2024
- Organization subpart
- No
Authorized official
- Name
- Ishtiaq Ahmad
- Title
- Owner
- Phone
- (706) 314-9735
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250716000292 | GA | DME Supplier - Pharmacy | 9931620317 | Practice locations: Rome, GA |
National Provider Directory
- Tax ID family
- Arrow Pharmacy
Locations
1102 N 5th Ave NE
Ste 200
Rome, GA 30165
Phone (706) 314-9735
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
1102 N 5TH Ave NE Ste 200
Rome, GA 30165-2623
Mailing address
1102 N 5TH Ave NE Ste 200
Rome, GA 30165-2623
Phone (706) 314-9735
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All providers in Rome, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.