Provider Demographics
NPI:1952515298
Name:ADAMS, JONATHAN DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3095 TYRONE PIKE
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-8860
Mailing Address - Country:US
Mailing Address - Phone:301-613-8976
Mailing Address - Fax:
Practice Address - Street 1:ROSWELL PARK CANCER INSTITUTE PHARMACY DEPARTMENT
Practice Address - Street 2:ELM AND CARLTON STREETS
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-3040
Practice Address - Fax:716-845-8726
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0516221835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology