Provider Demographics
NPI:1871543686
Name:ADAMS, SAMUEL B JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:B
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:239 ADAMS LN
Mailing Address - Street 2:PO BOX 413
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683-6113
Mailing Address - Country:US
Mailing Address - Phone:423-727-7408
Mailing Address - Fax:
Practice Address - Street 1:851 S SHADY ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-1831
Practice Address - Country:US
Practice Address - Phone:423-727-1210
Practice Address - Fax:423-727-1368
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC8222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist