Provider Demographics
NPI:1376524454
Name:ADAMS, GARY D JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:D
Last Name:ADAMS
Suffix:JR
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 1:7054 SPENCERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45806-9346
Mailing Address - Country:US
Mailing Address - Phone:419-224-6767
Mailing Address - Fax:
Practice Address - Street 1:927 N CABLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1747
Practice Address - Country:US
Practice Address - Phone:419-222-0778
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist