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NPI Code Detail

MEDICARE: ZACHARY SMITH

MEDICARE: ZACHARY SMITH
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
1183500000XPharmacistRP0010880WV

General Provider Information

NPI Number : 1992363253
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY SMITH
Provider Business Mailing Address
First Line : 120 BRAGG HOLLOW RD
Second Line :
City : FAYETTEVILLE
State : WV
Zip : 25840-5368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 131 WELLNESS DR
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-5402
Country : US
Telephone Number : 304-658-7039
Fax Number : 304-596-0915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2019
Last Update Date : 06/14/2022

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Directions to “ ZACHARY SMITH ” Practice Location

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