Basic Information
| Provider Information | |||||||||
| NPI: | 1295303220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAINES | ||||||||
| FirstName: | ADAM | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | CMR 402 BOX 1357 | ||||||||
| Address2: | |||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 091800014 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | LANDSTUHL REGIONAL MEDICAL CENTER | ||||||||
| Address2: | UNIT 33100 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145905222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2021 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 16623 | OK | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.