Provider Demographics
NPI:1588067656
Name:WOMACK, ADAM (PHARMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:WOMACK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 ZEAGER RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-8736
Mailing Address - Country:US
Mailing Address - Phone:177-944-3081
Mailing Address - Fax:
Practice Address - Street 1:16750 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9539
Practice Address - Country:US
Practice Address - Phone:623-546-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist