=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194408807
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADC PHARMACY SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2023
-----------------------------------------------------
Last Update Date | 06/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5503 SW 9TH AVE STE B
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79106-4124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-310-9226
-----------------------------------------------------
Fax | 806-437-1387
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 10003
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79116-0003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-310-9226
-----------------------------------------------------
Fax | 806-437-1387
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | STAN J/. BRITTEN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 806-353-2200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------