Provider Demographics
NPI:1427157585
Name:ADAMS, JOHN CLARENCE (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CLARENCE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-4012
Mailing Address - Country:US
Mailing Address - Phone:770-382-8707
Mailing Address - Fax:
Practice Address - Street 1:825 WEST AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-6133
Practice Address - Country:US
Practice Address - Phone:770-607-5897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist