Individual ProviderSamuel AdamsFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2201 Lexington Ave, Ashland, KY 41101-2843(606) 408-4000PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Adams is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1225018104Provider TypeIndividualFull NameAdams, SamuelCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date1/18/2006Last Updated5/31/2019Contact InformationPractice LocationPractice Address2201 Lexington Ave, Ashland, KY 41101-2843Phone(606) 408-4000Fax(606) 408-3841Mailing LocationMailing AddressPO Box 151, Ashland, KY 41105-0151Phone(606) 408-4000Fax(606) 408-3841Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense37206KentuckyCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense20454West VirginiaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseME139866FloridaProvider IdentifiersIDDescriptionIssuerID64039084DescriptionMedicaidIssuerUnlistedKentuckyID1807611000DescriptionMedicaidIssuerUnlistedWest VirginiaID2270260DescriptionMedicaidIssuerUnlistedOhio