Provider Demographics
NPI:1578307534
Name:ASM PHARMACY, LLC
Entity type:Organization
Organization Name:ASM PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-793-0811
Mailing Address - Street 1:224 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4964
Mailing Address - Country:US
Mailing Address - Phone:305-793-0811
Mailing Address - Fax:
Practice Address - Street 1:7041 GIRLS SCHOOL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-2821
Practice Address - Country:US
Practice Address - Phone:305-793-0811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASM PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy