Provider Demographics
NPI:1003840265
Name:ADAMS DRUG INC.
Entity Type:Organization
Organization Name:ADAMS DRUG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HADDON
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:308-882-4949
Mailing Address - Street 1:513 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:NE
Mailing Address - Zip Code:69033-3119
Mailing Address - Country:US
Mailing Address - Phone:308-882-4949
Mailing Address - Fax:308-882-3903
Practice Address - Street 1:513 BROADWAY
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:NE
Practice Address - Zip Code:69033-3119
Practice Address - Country:US
Practice Address - Phone:308-882-4949
Practice Address - Fax:308-882-3903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid