Provider Demographics
NPI:1336749860
Name:ADEPA PHARMACY PLLC
Entity Type:Organization
Organization Name:ADEPA PHARMACY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU-BOADI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:520-370-9770
Mailing Address - Street 1:8770 N THORNYDALE RD STE 190
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9096
Mailing Address - Country:US
Mailing Address - Phone:520-370-9770
Mailing Address - Fax:520-244-1677
Practice Address - Street 1:8770 N THORNYDALE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-9096
Practice Address - Country:US
Practice Address - Phone:480-310-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy