=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457611527
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZIMAN PHARMACEUTICAL SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2012
-----------------------------------------------------
Last Update Date | 05/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 SANDER ST
-----------------------------------------------------
City | WOODLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95776-5389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-867-3189
-----------------------------------------------------
Fax | 530-661-9090
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 73094
-----------------------------------------------------
City | DAVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95617-3094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-867-3189
-----------------------------------------------------
Fax | 530-661-9090
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MELANIE DECKER
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 530-867-3189
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | 62499
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1835X0200X
-----------------------------------------------------
Taxonomy Name | Oncology Pharmacist
-----------------------------------------------------
License Number | 62499
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1835P1200X
-----------------------------------------------------
Taxonomy Name | Pharmacotherapy Pharmacist
-----------------------------------------------------
License Number | 62499
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------