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General NPI Number Information
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NPI Number | 1083295562
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Entity Type | Individual
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Provider Name | ZACHRY LANE ADORNETTO
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Gender | Male
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | HWY 191, HOSPITAL ROAD
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City | CHINLE
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State | AZ
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Zip | 86503
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Country | US
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Telephone | 928-674-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 15200 HIGHWAY 152
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City | MOBEETIE
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State | TX
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Zip | 79061-4712
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Country | US
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Telephone | 432-413-3695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 67740
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19010
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License Number State | OK
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