Healthcare Provider Details

I. General information

NPI: 1760318042
Provider Name (Legal Business Name): ZACHARY RICHARDSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 NEW CLYDE HWY
CANTON NC
28716-4232
US

IV. Provider business mailing address

244 NEW CLYDE HWY
CANTON NC
28716-4232
US

V. Phone/Fax

Practice location:
  • Phone: 828-648-4468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34407
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: