Provider Demographics
NPI:1265740633
Name:WHITESCARVER, ADAM COLBY (RPH)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:COLBY
Last Name:WHITESCARVER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1835 E GUADALUPE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3277
Mailing Address - Country:US
Mailing Address - Phone:480-838-0448
Mailing Address - Fax:480-730-9860
Practice Address - Street 1:1835 E GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3277
Practice Address - Country:US
Practice Address - Phone:480-838-0448
Practice Address - Fax:480-730-9860
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS010664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist