Basic Information
Provider Information
NPI: 1336786722
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEPRAH-ASANTE
FirstName: FRANK
MiddleName: AKWASI
NamePrefix: DR.
NameSuffix:  
Credential: PHARMACIST
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9985 NW 19TH RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326069254
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: LAKE CITY VA MEDICAL CENTER
Address2: 619 SOUTH MARION AVENUE
City: LAKE CITY
State: FL
PostalCode: 320255808
CountryCode: US
TelephoneNumber: 3867553016
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/04/2019
LastUpdateDate: 12/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPS37231FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


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