Provider Demographics
NPI:1487282893
Name:ADAIR, KRISTI RAE (PHARM D)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:RAE
Last Name:ADAIR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 GRIGGSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CALVERT CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42029-8699
Mailing Address - Country:US
Mailing Address - Phone:270-703-9646
Mailing Address - Fax:
Practice Address - Street 1:805 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1240
Practice Address - Country:US
Practice Address - Phone:270-527-9374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty