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NPI Code Detail

MEDICARE: RYAN ADES

MEDICARE:   RYAN  ADES
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
11835P1200XPharmacotherapy Pharmacist26024052AIN

General Provider Information

NPI Number : 1588076863
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ADES
Provider Business Mailing Address
First Line : 10728 ALDERWOOD LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1004
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6309 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-1425
Country : US
Telephone Number : 260-497-1010
Fax Number : 260-497-1065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2014
Last Update Date : 05/21/2014

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Directions to “ RYAN ADES ” Practice Location

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