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General NPI Number Information
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NPI Number | 1629621099
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Entity Type | Individual
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Provider Name | ZACHARY DORWORTH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 1646 W MONTEBELLO AVE
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City | PHOENIX
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State | AZ
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Zip | 85015-2557
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Country | US
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Telephone | 602-293-4523
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Fax |
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Provider Business Mailing Address
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Address Line | 9240 E REDFIELD RD APT 323
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3708
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Country | US
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Telephone | 513-748-9460
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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 | S022656
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License Number State | AZ
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