Provider Demographics
NPI:1083918619
Name:ADAMS PROFESSIONAL PHARMACY LLC
Entity Type:Organization
Organization Name:ADAMS PROFESSIONAL PHARMACY LLC
Other - Org Name:ADAM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN PHARMACY
Authorized Official - Phone:304-620-0777
Mailing Address - Street 1:110 BAUGHMANS LN
Mailing Address - Street 2:FL 1
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4059
Mailing Address - Country:US
Mailing Address - Phone:301-620-0777
Mailing Address - Fax:301-620-7007
Practice Address - Street 1:110 BAUGHMANS LN
Practice Address - Street 2:FL 1
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4059
Practice Address - Country:US
Practice Address - Phone:301-620-0777
Practice Address - Fax:301-620-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP05415333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy