Provider Demographics
NPI:1528341245
Name:BESUFEKAD, ASTER ZEWDIE
Entity type:Individual
Prefix:
First Name:ASTER
Middle Name:ZEWDIE
Last Name:BESUFEKAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 S TUMBLEBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3094
Mailing Address - Country:US
Mailing Address - Phone:303-359-1891
Mailing Address - Fax:
Practice Address - Street 1:11650 S TUMBLEBRUSH ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3094
Practice Address - Country:US
Practice Address - Phone:303-359-1758
Practice Address - Fax:303-482-2830
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist