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NPI Code Detail

MEDICARE: MR. ADAM D BOON PHARMD

MEDICARE:  MR. ADAM D BOON  PHARMD
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
1183500000XPharmacist26021100AIN

General Provider Information

NPI Number : 1730184953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADAM D BOON PHARMD
Provider Business Mailing Address
First Line : 1419 S NANCY ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47401-6051
Country : US
Telephone Number : 812-339-0574
Fax Number :
Provider Business Practice Location Address
First Line : 2900 16TH ST
Second Line :
City : BEDFORD
State : IN
Zip : 47421-3510
Country : US
Telephone Number : 812-275-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 07/08/2007

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Directions to “ MR. ADAM D BOON PHARMD” Practice Location

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