MEDICARE: STEVE ZACZYK 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	RP443288	PA

General Provider Information

NPI Number	:	1740758523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE ZACZYK PHARMD

Provider Business Mailing Address
First Line	:	100 PAINTERS MILL RD STE 500
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-7304
Country	:	US
Telephone Number	:	814-282-6964
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 PAINTERS MILL RD STE 500
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-7304
Country	:	US
Telephone Number	:	814-282-6964
Fax Number	:

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

Provider Enumeration Date	:	11/09/2018
Last Update Date	:	11/09/2018

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