Individual
LARRY SHANE ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
1308 S MAIN ST, KINGFISHER, OK 73750-4408
(405) 375-5400
(405) 375-6333
Mailing address
1308 S MAIN ST, KINGFISHER, OK 73750-4408
(405) 375-5400
(405) 375-6333
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
11557
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11557
PHARMACY LICENSE
OK
Enumeration date
03/11/2019
Last updated
03/11/2019
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