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NPI 1306132550

NPI 1306132550 : ROBERT ANTHONY ZIPPRICH JR. RPH : JACKSONVILLE, IL

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General NPI Number Information
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    NPI Number           |    1306132550
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT ANTHONY ZIPPRICH JR. RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/27/2011
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    Last Update Date     |    06/27/2011
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Provider Practice Location Address
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    Address Line         |    134 W MORTON AVE 
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    City                 |    JACKSONVILLE
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    State                |    IL
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    Zip                  |    62650-2811
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    Country              |    US
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    Telephone            |    217-243-7818
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    867 W CHAMBERS ST 
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    City                 |    JACKSONVILLE
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    State                |    IL
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    Zip                  |    62650-2369
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    Country              |    US
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    Telephone            |    217-243-5250
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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       |    051.030630
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    License Number State |    IL
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