Provider Demographics
NPI:1285029520
Name:ADAMS PHARMACY LLC
Entity Type:Organization
Organization Name:ADAMS PHARMACY LLC
Other - Org Name:ADAMS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-250-0562
Mailing Address - Street 1:1373 DIX HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-1346
Mailing Address - Country:US
Mailing Address - Phone:313-381-0070
Mailing Address - Fax:313-381-0071
Practice Address - Street 1:1373 DIX HWY
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-1346
Practice Address - Country:US
Practice Address - Phone:313-381-0070
Practice Address - Fax:313-381-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010107043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy