MEDICARE: ZACHARY HANUSCHOCK 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
1	183500000X	Pharmacist	RP456608	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RPI015669	OTHER	PA	PENNSYLVANIA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1255079349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY HANUSCHOCK PHARMD

Provider Business Mailing Address
First Line	:	201 PITTSBURGH ST
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-2772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4534 BROADWAY BLVD
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-4745
Country	:	US
Telephone Number	:	412-373-5420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

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