=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639255185
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAMS PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 12/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 309 N HAMPTON RD
-----------------------------------------------------
City | DESOTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75115-4915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-223-0444
-----------------------------------------------------
Fax | 972-223-2176
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 309 N HAMPTON RD
-----------------------------------------------------
City | DESOTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75115-4915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-223-0444
-----------------------------------------------------
Fax | 972-223-2176
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST PRESIDENT
-----------------------------------------------------
Name | MR. ROBERT SHERMAN ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-223-0444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------