Provider Demographics
NPI:1578809638
Name:ADAIR DRUG,LLC
Entity Type:Organization
Organization Name:ADAIR DRUG,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAGENE
Authorized Official - Middle Name:STEPHENS
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:RCPHT
Authorized Official - Phone:270-584-9999
Mailing Address - Street 1:510 BURKESVILLE ST.
Mailing Address - Street 2:SUITE #1
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-0101
Mailing Address - Country:US
Mailing Address - Phone:270-384-9999
Mailing Address - Fax:270-384-2133
Practice Address - Street 1:510 BURKESVILLE ST
Practice Address - Street 2:SUITE #1
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1610
Practice Address - Country:US
Practice Address - Phone:270-805-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X
KYP07547333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
7165950001Medicare NSC