Healthcare Provider Details

I. General information

NPI: 1508476227
Provider Name (Legal Business Name): ZACHARY URAM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 MARION WALDO RD
MARION OH
43302-7422
US

IV. Provider business mailing address

1428 MARION WALDO RD
MARION OH
43302-7422
US

V. Phone/Fax

Practice location:
  • Phone: 740-386-2321
  • Fax:
Mailing address:
  • Phone: 740-386-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03439925
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: