Healthcare Provider Details

I. General information

NPI: 1659403871
Provider Name (Legal Business Name): ZACHARY R POOL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL ROAD
CROW AGENCY MT
59022
US

IV. Provider business mailing address

PO BOX 9
CROW AGENCY MT
59022-0009
US

V. Phone/Fax

Practice location:
  • Phone: 406-638-2626
  • Fax: 406-638-3326
Mailing address:
  • Phone: 406-638-2626
  • Fax: 406-638-3326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number12412
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: