Matthew Adcock, RPH
Individual provider Active NPI Pharmacist · East Dublin, GA
NPI 1831407386 · NPPES record last updated Sep 21, 2010
Key facts
- NPI
- 1831407386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17553 (GA)
- Practice address
- 705 Central Dr
East Dublin, GA 31027-7507 - Phone
- (478) 296-7336
- Fax
- (478) 296-7735
- NPI assigned
- Sep 17, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17553 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17553 | GA | Yes |
Addresses
Primary practice location
705 Central Dr
East Dublin, GA 31027-7507
Mailing address
705 Central Dr
East Dublin, GA 31027-7507
Phone (478) 296-7336
Other providers in East Dublin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.