Provider Demographics
NPI:1689965717
Name:ADAMS, GREG (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 WESTSIDE RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-4833
Mailing Address - Country:US
Mailing Address - Phone:530-243-3616
Mailing Address - Fax:530-243-0981
Practice Address - Street 1:6424 WESTSIDE RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-4833
Practice Address - Country:US
Practice Address - Phone:530-243-3616
Practice Address - Fax:530-243-0981
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist