Healthcare Provider Details

I. General information

NPI: 1710504188
Provider Name (Legal Business Name): ADAM O ZAYED PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HEALTH CTR RD, KYLE, SD 57752
KYLE SD
57752
US

IV. Provider business mailing address

1000 HEALTH CTR RD, KYLE, SD 57752
KYLE SD
57752
US

V. Phone/Fax

Practice location:
  • Phone: 605-455-2451
  • Fax:
Mailing address:
  • Phone: 605-455-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051300350
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: