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
—
—
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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