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General NPI Number Information
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NPI Number | 1508466475
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Entity Type | Individual
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Provider Name | JEREMY ADKINS
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Gender | Male
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 112 OSBOURNE WAY
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City | GEORGETOWN
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State | KY
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Zip | 40324-9636
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Country | US
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Telephone | 502-867-1935
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Fax |
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Provider Business Mailing Address
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Address Line | 116 ROLLING RIDGE RD
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City | STAMPING GROUND
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State | KY
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Zip | 40379-9528
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Country | US
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Telephone | 606-434-2184
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 017049
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License Number State | KY
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