Healthcare Provider Details

I. General information

NPI: 1578352654
Provider Name (Legal Business Name): ZIKS FAMILY PHARMACY INC 102
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W 3RD ST
DAYTON OH
45402-6834
US

IV. Provider business mailing address

1120 W 3RD ST
DAYTON OH
45402-6834
US

V. Phone/Fax

Practice location:
  • Phone: 937-225-9350
  • Fax: 937-225-9355
Mailing address:
  • Phone: 937-225-9350
  • Fax: 937-275-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NNODUM IHEME
Title or Position: PRESIDENT
Credential: R.PH
Phone: 513-739-6293