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NPI Code Detail

MEDICARE: ZACHARIAH VAUGHN PHARMD

MEDICARE:   ZACHARIAH  VAUGHN  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPD15808AR

General Provider Information

NPI Number : 1023689262
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARIAH VAUGHN PHARMD
Provider Business Mailing Address
First Line : 3475 BLACK FOREST DR
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72704-6524
Country : US
Telephone Number : 479-871-6158
Fax Number :
Provider Business Practice Location Address
First Line : 3475 BLACK FOREST DR
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72704-6524
Country : US
Telephone Number : 479-442-2276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2021
Last Update Date : 07/08/2021

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Directions to “ ZACHARIAH VAUGHN PHARMD” Practice Location

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