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General NPI Number Information
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NPI Number | 1982388971
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Entity Type | Organization
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Legal Business Name | ADELAIDE APOTHECARY, LLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 160 MOORE DR STE 105
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City | LEXINGTON
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State | KY
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Zip | 40503-2970
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Country | US
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Telephone | 859-909-8520
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Fax | 859-909-8519
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Provider Business Mailing Address
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Address Line | 160 MOORE DR STE 105
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City | LEXINGTON
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State | KY
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Zip | 40503-2970
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Country | US
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Telephone | 859-909-8520
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Fax | 859-909-8519
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | JILL SMITH
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Credential |
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Telephone | 859-909-8520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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