Provider Demographics
NPI:1144509639
Name:CASEY, ADAM NEGM (PHARMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:NEGM
Last Name:CASEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HAYMARKET ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-7204
Mailing Address - Country:US
Mailing Address - Phone:609-980-4509
Mailing Address - Fax:
Practice Address - Street 1:2304 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5416
Practice Address - Country:US
Practice Address - Phone:307-635-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist