MEDICARE: ADAIR APOTHECARY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	50-001648	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285625038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAIR APOTHECARY, LLC

Provider Business Mailing Address
First Line	:	911 W MAIN ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360-2605
Country	:	US
Telephone Number	:	864-984-2696
Fax Number	:	864-984-4454

Provider Business Practice Location Address
First Line	:	911 W MAIN ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360-2605
Country	:	US
Telephone Number	:	864-984-2696
Fax Number	:	864-984-4454

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM FORREST ADAIR SR.
Credential	:	R.PH.
Telephone Number	:	864-984-2696

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	11/10/2015

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Directions to “ADAIR APOTHECARY, LLC ” Practice Location

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