Healthcare Provider Details

I. General information

NPI: 1801198809
Provider Name (Legal Business Name): LEE ADAM WORTH PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 11/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAPITOL AVE
SACRAMENTO CA
95814-5006
US

IV. Provider business mailing address

1500 CAPITOL AVE
SACRAMENTO CA
95814-5006
US

V. Phone/Fax

Practice location:
  • Phone: 916-319-8173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberRPH42730
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License NumberRPH42730
License Number State
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH42730
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH42730
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH42730
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberRPH42730
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: