Provider Demographics
NPI:1083043897
Name:ADAMS, DESLYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DESLYN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 FOREST LAKES AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-3242
Mailing Address - Country:US
Mailing Address - Phone:404-293-3875
Mailing Address - Fax:
Practice Address - Street 1:715 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-2657
Practice Address - Country:US
Practice Address - Phone:229-896-2300
Practice Address - Fax:229-896-1350
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist