Provider Demographics
NPI:1205565694
Name:ADENA PHARMACY LLC
Entity type:Organization
Organization Name:ADENA PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULATORY PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:740-779-8760
Mailing Address - Street 1:272 HOSPITAL ROAD
Mailing Address - Street 2:ATTN: MICHAEL JOHNSON
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601
Mailing Address - Country:US
Mailing Address - Phone:740-779-8638
Mailing Address - Fax:740-779-8769
Practice Address - Street 1:2 E A ST
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-1210
Practice Address - Country:US
Practice Address - Phone:740-384-7715
Practice Address - Fax:740-384-7719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADENA PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-09
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy