Healthcare Provider Details

I. General information

NPI: 1033468863
Provider Name (Legal Business Name): MAX ZILER PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 JOSHUA M FREEMAN BLVD
RANSON WV
25438
US

IV. Provider business mailing address

74 JOSHUA M FREEMAN BLVD
RANSON WV
25438
US

V. Phone/Fax

Practice location:
  • Phone: 304-728-7713
  • Fax: 304-728-7766
Mailing address:
  • Phone: 304-728-7713
  • Fax: 304-728-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0007975
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: