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General NPI Number Information
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NPI Number | 1265716385
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Entity Type | Individual
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Provider Name | ZACHARY D SMITH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 2410 N COLISEUM BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46805-3110
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Country | US
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Telephone | 260-483-5612
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Fax |
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Provider Business Mailing Address
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Address Line | 9834 DUPONT LAKES DR APT 3B
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City | FORT WAYNE
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State | IN
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Zip | 46825
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Country | US
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Telephone | 419-203-3182
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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 | 26023729A
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License Number State | IN
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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 | RPH.03230322-2
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License Number State | OH
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