Provider Demographics
NPI:1801956701
Name:ADKINS PHARMACY INC
Entity type:Organization
Organization Name:ADKINS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-664-8883
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:PO BOX 1537
Mailing Address - City:GILBERT
Mailing Address - State:WV
Mailing Address - Zip Code:25621-1537
Mailing Address - Country:US
Mailing Address - Phone:304-664-8883
Mailing Address - Fax:304-664-9236
Practice Address - Street 1:81 STATE ROUTE 80
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:WV
Practice Address - Zip Code:25621-1537
Practice Address - Country:US
Practice Address - Phone:304-664-8883
Practice Address - Fax:304-664-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSP05506971835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0138941000Medicaid
WV1089910001Medicare NSC