MEDICARE: GARY JOSEPH ADAMS RPH

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	183500000X	Pharmacist	5302023910	MI

General Provider Information

NPI Number	:	1538781547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY JOSEPH ADAMS RPH

Provider Business Mailing Address
First Line	:	50429 INDEPENDENCE ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-6735
Country	:	US
Telephone Number	:	734-544-1278
Fax Number	:	734-544-1284

Provider Business Practice Location Address
First Line	:	50429 INDEPENDENCE ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-6735
Country	:	US
Telephone Number	:	734-544-1278
Fax Number	:	734-544-1284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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Directions to “ GARY JOSEPH ADAMS RPH” Practice Location

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