Provider Demographics
NPI:1588630032
Name:ADHERERX INCORPORATED
Entity Type:Organization
Organization Name:ADHERERX INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-346-0880
Mailing Address - Street 1:118 MACKENAN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3600
Mailing Address - Country:US
Mailing Address - Phone:919-463-5555
Mailing Address - Fax:919-465-5812
Practice Address - Street 1:118 MACKENAN DR STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3600
Practice Address - Country:US
Practice Address - Phone:919-463-5555
Practice Address - Fax:919-465-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64001924A3336C0003X
GAPHNR0001983336C0003X
FLPH261103336C0003X
TX282673336C0003X
AZY0068183336C0003X
NC108953336C0003X
NJ28RO000967003336C0003X
KYNC17533336C0003X
MDP054993336C0003X
TN00000057943336C0003X
VA02140016463336C0003X
NY0326963336C0003X
SC114673336C0003X
PANP0002763336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0511382Medicaid
GA003122226AMedicaid
SC7N8177Medicaid
TX580128Medicaid
PA102692259 0001Medicaid
AZ131766Medicaid
MD332228900Medicaid
NC0920567Medicaid
KY7100287090Medicaid
IN201327340 AMedicaid
2069504OtherPK
DC093397400Medicaid
AZ131766Medicaid