Provider Demographics
NPI:1164035812
Name:PARKER, ADAM NICHOLAS (RPH)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:NICHOLAS
Last Name:PARKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 JACKSON RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:VA
Mailing Address - Zip Code:24465-2416
Mailing Address - Country:US
Mailing Address - Phone:540-468-6425
Mailing Address - Fax:
Practice Address - Street 1:120 JACKSON RIVER RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:VA
Practice Address - Zip Code:24465-2416
Practice Address - Country:US
Practice Address - Phone:540-468-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist