Individual
DR. JACK LORAN ADAMS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH., PHARM. D.
Contact information
Practice address
3015 VETERANS PKWY S, MOULTRIE, GA 31788-6705
(229) 985-4815
Mailing address
757 CIRCLE RD, MOULTRIE, GA 31768-4253
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH018926
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH018926
STATE LICENSE NUMBER
GA
Enumeration date
08/30/2006
Last updated
04/18/2018
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