Healthcare Provider Details

I. General information

NPI: 1154698223
Provider Name (Legal Business Name): ZACHARY JOHN HEFNER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E MEIGHAN BLVD
GADSDEN AL
35903-1044
US

IV. Provider business mailing address

2707 WHITEOAK DR
SOUTHSIDE AL
35907-7037
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-4717
  • Fax:
Mailing address:
  • Phone: 256-442-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12296
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: