Healthcare Provider Details

I. General information

NPI: 1265006423
Provider Name (Legal Business Name): WEN QIANG ZHU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 EXECUTIVE BLVD
HUBER HEIGHTS OH
45424-1412
US

IV. Provider business mailing address

9088 MANDEL DR
DAYTON OH
45458-3807
US

V. Phone/Fax

Practice location:
  • Phone: 937-237-4610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03134698
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: