Healthcare Provider Details

I. General information

NPI: 1194219790
Provider Name (Legal Business Name): ZACHARY BRIAN KERNS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 N HIGH ST
COLUMBUS OH
43201-2409
US

IV. Provider business mailing address

109 JEFFERSON ST
GREENFIELD OH
45123-1364
US

V. Phone/Fax

Practice location:
  • Phone: 614-340-6776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03237199
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: