Provider Demographics
NPI:1073815478
Name:ZIEMBA, BRIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:ZIEMBA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8521 MOUNT VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-6931
Mailing Address - Country:US
Mailing Address - Phone:315-404-9070
Mailing Address - Fax:
Practice Address - Street 1:8521 MOUNT VALLEY LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-6931
Practice Address - Country:US
Practice Address - Phone:315-404-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist