Provider Demographics
NPI:1356633283
Name:ADAMS, MICHELE RENE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:RENE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8557 CHERRYRIDGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-9653
Mailing Address - Country:US
Mailing Address - Phone:330-854-5950
Mailing Address - Fax:
Practice Address - Street 1:2220 S. LOCUST ST
Practice Address - Street 2:
Practice Address - City:CANAL FULTON
Practice Address - State:OH
Practice Address - Zip Code:44614
Practice Address - Country:US
Practice Address - Phone:330-854-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist