Provider Demographics
NPI:1679177695
Name:OLIVER, ADAM TODD (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:TODD
Last Name:OLIVER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1630
Mailing Address - Country:US
Mailing Address - Phone:859-623-7481
Mailing Address - Fax:859-623-7906
Practice Address - Street 1:409 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1630
Practice Address - Country:US
Practice Address - Phone:859-623-7481
Practice Address - Fax:859-623-7906
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist