Provider Demographics
NPI:1679160683
Name:ADAMS, EDWARD ANTHONY
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:ANTHONY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1505
Mailing Address - Country:US
Mailing Address - Phone:781-749-5856
Mailing Address - Fax:
Practice Address - Street 1:400 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1505
Practice Address - Country:US
Practice Address - Phone:781-749-5856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist