Provider Demographics
NPI:1013386606
Name:PAYNE, ZACHARY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:PAYNE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 S CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5279
Mailing Address - Country:US
Mailing Address - Phone:423-586-0251
Mailing Address - Fax:
Practice Address - Street 1:922 S CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-5279
Practice Address - Country:US
Practice Address - Phone:423-586-0251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN39754OtherTENNESSE BOARD OF PHARMACY