Provider Demographics
NPI:1962126615
Name:DOLAN, ADAM D (RPH)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:DOLAN
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 1:5315 E HIGH ST UNIT 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5441
Mailing Address - Country:US
Mailing Address - Phone:620-757-8561
Mailing Address - Fax:
Practice Address - Street 1:3950 BRODHEAD RD STE 100
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3030
Practice Address - Country:US
Practice Address - Phone:877-836-9925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021031823183500000X
KS1-103649183500000X
AZS025780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist