Healthcare Provider Details

I. General information

NPI: 1003840265
Provider Name (Legal Business Name): ADAMS DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROADWAY
IMPERIAL NE
69033-3119
US

IV. Provider business mailing address

513 BROADWAY
IMPERIAL NE
69033-3119
US

V. Phone/Fax

Practice location:
  • Phone: 308-882-4949
  • Fax: 308-882-3903
Mailing address:
  • Phone: 308-882-4949
  • Fax: 308-882-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2096
License Number StateNE

VIII. Authorized Official

Name: MR. JAMES HADDON HANES
Title or Position: PRESIDENT/PHARMACIST
Credential: RPH
Phone: 308-882-4949