Provider Demographics
NPI:1972623452
Name:ADAMS, ROBERT E JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:LA
Mailing Address - Zip Code:71263-8720
Mailing Address - Country:US
Mailing Address - Phone:318-450-1997
Mailing Address - Fax:
Practice Address - Street 1:727 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-3003
Practice Address - Country:US
Practice Address - Phone:318-283-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist