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General NPI Number Information
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NPI Number | 1659475606
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Entity Type | Organization
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Legal Business Name | ZOOT ENTERPRISES INC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 832 TURNER MCCALL BLVD SW
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City | ROME
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State | GA
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Zip | 30161-2927
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Country | US
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Telephone | 706-291-7850
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Fax | 706-291-0575
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Provider Business Mailing Address
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Address Line | 832 TURNER MCCALL BLVD SW
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City | ROME
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State | GA
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Zip | 30161-2927
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Country | US
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Telephone | 706-291-7850
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Fax | 706-291-0575
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Authorized Official
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Title or Position | VP
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Name | ANN MOSS
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Credential | RPH
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Telephone | 706-291-7850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE007324
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License Number State | GA
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