Provider Demographics
NPI:1285239749
Name:ASANTE, KWADWO (PHARMD)
Entity type:Individual
Prefix:
First Name:KWADWO
Middle Name:
Last Name:ASANTE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 W BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1729
Mailing Address - Country:US
Mailing Address - Phone:508-835-3157
Mailing Address - Fax:508-835-3835
Practice Address - Street 1:264 W BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1729
Practice Address - Country:US
Practice Address - Phone:508-835-3157
Practice Address - Fax:508-835-3835
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist