Healthcare Provider Details

I. General information

NPI: 1285094797
Provider Name (Legal Business Name): ZOLA ISADORE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 BINGHAM DR
FAYETTEVILLE NC
28304-2842
US

IV. Provider business mailing address

906 BINGHAM DR
FAYETTEVILLE NC
28304-2842
US

V. Phone/Fax

Practice location:
  • Phone: 910-487-5359
  • Fax:
Mailing address:
  • Phone: 910-487-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25510
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: