Blakely Adams, PHARMD

Individual provider Active NPI Pharmacist · Moncks Corner, SC

NPI 1154046845 · NPPES record last updated Oct 5, 2022

Key facts

NPI
1154046845
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
43716 (SC)
Practice address
402 E Main St
Moncks Corner, SC 29461-3616
Phone
(843) 761-5255
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
43716SCMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 43716 SC Yes

Addresses

Primary practice location

402 E Main St
Moncks Corner, SC 29461-3616

Mailing address

468 E Shoreline Dr
North Augusta, SC 29841-5457
Phone (803) 507-5611

Other providers in Moncks Corner, SC

All providers in Moncks Corner, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.