Healthcare Provider Details

I. General information

NPI: 1891392619
Provider Name (Legal Business Name): HEALTH MANAGEMENT ZONE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 10/05/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N CENTER ST
MARYVILLE IL
62062-5624
US

IV. Provider business mailing address

2700 N CENTER ST
MARYVILLE IL
62062-5624
US

V. Phone/Fax

Practice location:
  • Phone: 618-406-0150
  • Fax:
Mailing address:
  • Phone: 618-406-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HARRY MICHAEL ZOLLARS
Title or Position: OWNER
Credential:
Phone: 618-288-7474