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General NPI Number Information
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NPI Number | 1750856753
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Entity Type | Individual
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Provider Name | ZACHARY TYSON SIMPSON
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Gender | Male
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Dates
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Enumeration Date | 10/06/2018
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 495 CHARLES HARDY PKWY
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City | DALLAS
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State | GA
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Zip | 30157-5723
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Country | US
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Telephone | 770-445-2128
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Fax |
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Provider Business Mailing Address
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Address Line | 8501 HIGH POINT RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-3114
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Country | US
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Telephone | 770-317-8849
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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 | RPH031015
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License Number State | GA
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