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Organization
ADENA PHARMACY LLC
Active
Organization
ADENA PHARMACY LLC
Active
Other names
Adena Pike Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHNSON (OUTPATIENT PHARMACY MANAGER)
(740) 779-8761
Entity
Organization
Contact information
Practice address
100 DAWN LN, WAVERLY, OH 45690-9138
(740) 947-6320
(740) 947-6301
Mailing address
100 DAWN LN, WAVERLY, OH 45690-9138
(740) 947-6376
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RTPC.022492650-03
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164501
—
OH
01
—
2150099
PK
—
Enumeration date
02/03/2015
Last updated
03/08/2017
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