Healthcare Provider Details

I. General information

NPI: 1730005950
Provider Name (Legal Business Name): JEFF ZEIGLER BROOKER IV
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BECKER DR
LAWRENCE KS
66047-1620
US

IV. Provider business mailing address

800 ADGER RD
COLUMBIA SC
29205-1912
US

V. Phone/Fax

Practice location:
  • Phone: 803-446-7423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3-118554
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: